Renin–angiotensin system blockade for the risk of cancer and death
نویسندگان
چکیده
INTRODUCTION The effects of renin-angiotensin system blockade with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) on cancer remain inconsistent. METHODS We searched existing databases from 1960 to August 2015, for randomised controlled trials and observational studies (case-control studies and cohort studies) of ARB/ACEI therapy with a minimal one year of follow-up. Outcomes were incidence and mortality of cancer. RESULTS We included 14 randomised controlled trials and 17 observational studies of 3,957,725 participants (350,329 ARB/ACEI users). The users had a lower incidence of cancer in the observational studies (RR 0.82, 95% CI 0.73-0.93) but not in the randomised controlled trials (RR 1.00, 95% CI 0.92-1.08). The protection persisted for lung cancer (RR 0.85, 95% CI 0.75-0.97) but not for other sites of cancer. The relative risk of cancer associated with renin-angiotensin system blockade was reduced along with time of follow-up. Mortality reduction with ARB/ACEI was marginally significant in the observational studies (RR 0.71, 95% CI 0.55-0.93) but not in the randomised controlled trials (RR 0.99, 95% CI 0.89-1.09). CONCLUSIONS The significant benefits of renin-angiotensin system blockade observed in case-control studies and cohort studies might diminish in randomised controlled trials. Clinical design, site of cancer and duration of follow-up may affect the clinical outcomes.
منابع مشابه
Roles of Renin-Angiotensin System in the Regulation of Prostate Cancer Bone Metastasis: A Critical Review
Mestastatic prostate cancer cells (MPCCs) frequently metastasize to bone, which is a “favorite soil” for colonization and proliferation of MPCCs. Prostate cancer bone mestastasis is tightly associated with tumor-induced bone lesions, most commonly caused from the etiological imbalance between osteoblastic bone formation and osteoclastic bone resorption, and from the anti-tumor immune response. ...
متن کاملIncreased Risk of Kidney Disorders in Patients with Coronavirus 2019: A Letter to the Editor
Background and Objectives: Coronavirus 2019 (Covid-19) has become a global disease that can affect various organs of the human body. Kidney disorders are the most common disorders in patients with Covid-19. Kidney involvement manifests as proteinuria and acute kidney injury (AKI). This virus can cause acute tubular necrosis, protein leakage in the Bowman's capsule, glomerulopathy, and mitochond...
متن کاملRenin-angiotensin system and unilateral ureteral obstruction
Unilateral ureteral obstruction (UUO) is a clinical scenario that leads to obstructive nephropathy. UUO alters the expression of many mediators in the ipsilateral kidney. Renin-angiotensin system (RAS) is involved in UUO. Angiotensin II (Ang II) and angiotensin 1-7 (Ang 1-7) as the main arms of RAS influence kidney function which may alter by UUO. Ang II via Ang II receptor subtypes I (AT1R) ...
متن کاملResveratrol Suppresses Cardiac Renin Angiotensin System in the Late Phase of Left Ventricular Hypertrophy
Background and objectives: Resveratrol(3,5,4′-trihydroxy-trans-stilbene) is a natural polyphenole phytoalexin which exerts potential cardioprotective effects, but the cellular and molecular mechanisms responsible for these effects are still unknown. Cardiac renin angiotensin system (RAS) over-activation plays an important role in pathogenesis of left ventricula...
متن کاملمقایسه مهار سه داروئی و دو داروئی سیستم رنین - آنژیوتانسین - آلدوسترون
Received: 19 Feb, 2010 Accepted: 26 May, 2010 Abstract Background & Aims : According to the clinical guidelines on chronic kidney disease with hypertension, combination therapy with multiple renin–angiotensin–aldosterone system (RAAS) blockers have been recommended as standard first-line therapy. To date, dual and triple blockade of the RAAS has been evaluated. The aim of this study was c...
متن کامل