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Angiotensin inhibition and malignancies: a review

T Rosenthal1, I Gavras

  • 1Department of Physiology and Pharmacology, Hypertension Research Unit, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. rtalma@post.tau.ac.il

Journal of Human Hypertension
|April 3, 2009
PubMed

Insights

Angiotensin-converting enzyme (ACE) inhibitors may influence cancer incidence, with proposed mechanisms and in vitro evidence. However, population studies remain inconclusive, suggesting a potential link with ACE genotypes and tumor behavior.

Area of Science:

  • Pharmacology and Oncology
  • Cardiovascular Drug Research
  • Cancer Epidemiology

Background:

  • Early reports suggested a reduced cancer incidence in patients using angiotensin-converting enzyme (ACE) inhibitors.
  • This observation prompted extensive research into potential pathophysiological mechanisms and epidemiological correlations.
  • Agents inhibiting the renin-angiotensin system were investigated for their anti-tumor effects.

Purpose of the Study:

  • To explore the proposed pathophysiological mechanisms behind the potential anti-cancer effects of ACE inhibitors.
  • To review and analyze population studies comparing cancer incidence in patients treated with renin-angiotensin system inhibitors versus the general population.
  • To investigate potential interactions between ACE genotypes and tumor susceptibility or behavior.

Main Methods:

  • Review of in vitro studies and experimental animal models exploring anti-tumor activity of ACE inhibitors.
  • Analysis of population-based studies comparing cancer incidence rates.
  • Investigation of genetic associations, specifically ACE genotypes, and their role in cancer susceptibility.

Main Results:

  • Several in vitro mechanisms were proposed for the potential anti-tumor activity of ACE inhibitors.
  • Experimental animal models supported these proposed anti-cancer effects.
  • Population studies yielded largely inconclusive results regarding the direct impact of ACE inhibitors on cancer incidence.

Conclusions:

  • While in vitro and animal studies suggest potential anti-tumor properties of ACE inhibitors, clinical evidence remains inconclusive.
  • A possible interaction between specific angiotensin-converting enzyme (ACE) genotypes and the susceptibility to certain tumor behaviors was suggested.
  • Further research is needed to clarify the role of ACE inhibitors and related genetic factors in cancer development and progression.

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