The aim of the present study was to clarify the influence of candesartan-based therapy
on subsequent carcinogenesis and cancer death in patients with coronary artery disease
with hypertension in a substudy of a multicenter, prospective, randomized, controlled
trial. That trial compared the effects of candesartan-based therapy with those of
non-angiotensin receptor blocker (ARB)-based standard therapy on major adverse cardiovascular
events. Hypertensive patients with coronary artery disease were randomly assigned
to receive either candesartan-based (n = 1,024) or non–ARB-based pharmacotherapy,
including angiotensin-converting enzyme inhibitors (n = 1,025). During a median follow-up
of 4.2 years, 1,606 adverse events (798 in the candesartan group and 808 in the non-ARB
standard group) were reported. Among them, new cancer occurred in 5.37% of subjects
in the candesartan group and 5.66% of subjects in the standard therapy group (hazard
ratio 0.95, 95% confidence interval 0.65 to 1.38). Cancer deaths occurred in 1.66%
in the candesartan group and 2.44% in the standard therapy group, respectively (hazard
ratio 0.74, 95% confidence interval 0.39 to 1.39). Kaplan-Meier estimates of survival
without new cancer and cancer deaths demonstrated that candesartan-based therapy does
not accelerate the occurrence of new cancer (log-rank, p = 0.84) or cancer death (p
= 0.39) compared to standard therapy. Advanced age and male gender were independently
and significantly correlated with the subsequent incidence of cancer. In conclusion,
the results of the present study suggest that candesartan-based therapy is not associated
with either carcinogenesis or cancer death compared to non-ARB standard therapy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials.Lancet Oncol. 2010; 11: 627-636
- Antihypertensive drugs and risk of cancer: network meta-analyses and trial sequential analyses of 324,168 participants from randomised trials.Lancet Oncol. 2011; 12: 65-82
- Use of angiotensin receptor blockers and the risk of cancer.Circulation. 2011; 123: 1729-1736
- Angiotensin II receptor blockers and risk of cancer in patients with systemic hypertension.Am J Cardiol. 2011; 107: 1028-1033
- Angiotensin II receptor blocker-based vs. non-angiotensin II receptor blocker-based therapy in patients with angiographically documented coronary artery disease and hypertension: the Heart Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary Artery Disease (HIJ-CREATE).Eur Heart J. 2009; 30: 1203-1212
- Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer?.Lancet. 1998; 352: 179-184
- Blockade of angiotensin AT1a receptor signaling reduces tumor growth, angiogenesis, and metastasis.Biochem Biophys Res Commun. 2002; 294: 441-447
- Role of host angiotensin II type 1 receptor in tumor angiogenesis and growth.J Clin Invest. 2003; 112: 67-75
- Angiotensin II type I antagonist prevents pulmonary metastasis of murine renal cancer by inhibiting tumor angiogenesis.Cancer Res. 2002; 62: 4176-4179
- Effects of telmisartan, irbesartan, valsartan, candesartan, and losartan on cancers in 15 trials enrolling 138,769 individuals.J Hypertens. 2011; 29: 623-635
- Angiotensin receptor blockade and risk of cancer in type 2 diabetes mellitus: a nationwide case-control study.J Clin Oncol. 2011; 29: 3001-3007
- Cancer incidence and incidence rates in Japan in 2005: based on data from 12 population-based cancer registries in the Monitoring of Cancer Incidence in Japan (MCIJ) project.Jpn J Clin Oncol. 2011; 41: 139-147
Article info
Publication history
Published online: November 18, 2011
Accepted:
September 29,
2011
Received in revised form:
September 29,
2011
Received:
August 9,
2011
Footnotes
This trial was funded by the Japan Research Promotion Society for Cardiovascular Diseases, Tokyo, Japan, which had no role in the study design, data collection, data analysis, data interpretation, or writing of this report.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
