Critical review of cancer risk associated with angiotensin receptor blocker therapy

Grégoire Wuerzner1,3, Michel Burnier1, Bernard Waeber2,31Service of Nephrology and Hypertension Consultation, Centre Hospitalier Universitaire Vaudois, 2Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois, 3Clinical Research Centre, Unil/Centre Hospitalier Universitaire Vaudois, Lausanne, SwitzerlandAbstract: The role of drugs in new cancer occurrence and cancer-related death is a major concern. Recently, a meta-analysis raised the possibility that angiotensin receptor blockers (ARBs) might have an adverse effect on patients. This generated a significant debate until the publication of two further meta-analyses, neither of which demonstrated an increased risk of new cancer occurrence or cancer-related death with the use of ARBs in patients with hypertension, heart failure, and/or nephropathy. This illustrates that the results of meta-analyses should be interpreted cautiously and critically as bias, such as selection bias, might lead to erroneous conclusions. Overall, the bulk of evidence today indicates that ARBs are not associated with increased cancer risk.Keywords: hypertension, cancer, angiotensin receptor blocker, meta-analyses