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Risk of cancer associated with the use of angiotensin II-receptor blockers

Jacqueline L Olin1, Angie Veverka, Donald S Nuzum

  • 1School of Pharmacy, Wingate University, 515 North Main Street, Wingate, NC 28174, USA. jolin@wingate.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|November 8, 2011
PubMed
Abstract

Insights

Angiotensin II-receptor blockers (ARBs) are not definitively linked to increased cancer risk. Current evidence suggests ARBs may even offer protection against malignancy.

Area of Science:

  • Cardiovascular Pharmacology
  • Oncology
  • Molecular Biology

Background:

  • The renin-angiotensin system (RAS) plays a role in cardiovascular regulation and has been implicated in cancer development.
  • Angiotensin II (Ang II) and its receptors (AT1R, AT2R) are key components of the RAS, influencing cell proliferation and angiogenesis.
  • Angiotensin II-receptor blockers (ARBs) are widely used to manage hypertension and heart failure.

Purpose of the Study:

  • To review the proposed mechanisms by which Ang II and ARBs influence cancer risk.
  • To examine the existing literature on the potential causal relationship between ARB use and specific cancers.
  • To synthesize preclinical and clinical data regarding the RAS, ARBs, and malignancy.

Main Methods:

  • Comprehensive literature search for studies on Ang II, ARBs, cancer, and malignancy.
  • Inclusion of preclinical studies investigating the effects of Ang II and ARBs on proliferation and angiogenesis.
  • Analysis of human studies evaluating ARB use in relation to specific cancer types.

Main Results:

  • Preclinical data suggest Ang II agonism of AT1R and unopposed AT2R stimulation may promote proliferation and angiogenesis.
  • A meta-analysis indicated a modest increase in cancer incidence risk with ARB use, prompting further population studies.
  • Human studies provided limited patient-specific data to substantiate a causal link between ARBs and cancer.

Conclusions:

  • Insufficient evidence currently exists to conclude that ARBs increase cancer risk.
  • Blockade of both AT1 and AT2 receptors by ARBs might confer a protective effect against cancer.
  • Regulatory bodies like the FDA have found no evidence of increased cancer risk associated with ARB use.

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