Angiotensin-receptor blockers for blood pressure linked to cancer

If you are taking an angiotensin-receptor blocker (ARB) such as telmisartan (Micardis) or ramipril (Altace) it would be good to discuss changing to another medication in light of a serious risk factor for cancer brought to light in research published in the The Lancet Oncology. ARBs affect the renin-angiotensin system that regulates tension in the circulatory system; as the authors note:

"Experimental studies implicate the renin-angiotensin system, particularly angiotensin II type-1 and type-2 receptors, in the regulation of cell proliferation, angiogenesis, and tumour progression. We assessed whether ARBs affect cancer occurrence with a meta-analysis of randomised controlled trials of these drugs."

They analyzed data from a number of trials involving tens of thousands of patients and came to this conclusion:

"This meta-analysis of randomised controlled trials suggests that ARBs are associated with a modestly increased risk of new cancer diagnosis."

An accompanying editorial in the same issue expresses the gravity of this matter:

"The meta-analysis...is disturbing and provocative, raising crucial drug safety questions for practitioners and the regulatory community."

Why use this class of medications when there is no evidence that they are more effective than others? A functional approach obviating the need for side-effect producing drugs is often successful if instituted early enough. While research data continues to accumulate about ARBs the author exhorts us to take this finding into serious and cautious consideration when determining the best approach to blood pressure for each person:

"In the interim, we should use ARBs, particularly telmisartan, with greater caution. These drugs are often overprescribed, as a result of aggressive marketing and in the absence of evidence that they are better than angiotensin-converting enzyme (ACE) inhibitors."