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CRC Risk Down With ACEi, Angiotensin Receptor Blocker Use

Adjusted hazard ratio risk reduced 5 percent with each single-year increase in drug use


MONDAY, July 6, 2020 (HealthDay News) -- The use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers is associated with a lower risk for colorectal cancer that develops within three years after index colonoscopy, according to a study published online July 6 in Hypertension.

Ka Shing Cheung, M.B.B.S., from the University of Hong Kong, and colleagues examined the association between use of ACE inhibitors and angiotensin receptor blockers and colorectal cancer risk after a negative baseline colonoscopy among patients aged ≥40 years who underwent colonoscopy between 2005 and 2013. Data were included for 187,897 eligible patients, of whom 16.4 percent were ACE inhibitor/angiotensin receptor blocker users.

The researchers found that at six to 36 months after index colonoscopy, 854 patients (0.45 percent) developed colorectal cancer. A reduced risk for colorectal cancer that developed less than three years after index colonoscopy (adjusted hazard ratio, 0.78; 95 percent confidence interval, 0.64 to 0.96) but not more than three years (adjusted hazard ratio, 1.18; 95 percent confidence interval, 0.88 to 1.57) was seen in association with drug use. The investigators observed a 5 percent reduction in the adjusted hazard ratio risk with every single-year increase in drug use.

"Apart from side effects and contraindications, compelling indication is another factor to be considered in the choice of a particular antihypertensive medication," the authors write. "Our study provided additional insights into the potential chemopreventive effects of ACE inhibitors/angiotensin receptor blockers against colorectal cancer development, apart from their known cardiovascular and renal benefits."

Two authors disclosed financial ties to the pharmaceutical industry.

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