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Effects of telmisar...
Effects of telmisartan, irbesartan, valsartan, candesartan, and losartan on cancers in 15 trials enrolling 138 769 individuals The ARB Trialists Collaboration
- Article/chapterEnglish2011
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LIBRIS-ID:oai:DiVA.org:umu-104472
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-104472URI
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https://doi.org/10.1097/HJH.0b013e328344a7deDOI
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https://gup.ub.gu.se/publication/273429URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:for swepub-publicationtype
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Background Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) reduce cardiovascular disease (CVD) events, but a recent meta-analysis of selected studies suggested that ARBs may increase cancer risks.Objective Candesartan, irbesartan, telmisartan, valsartan, and losartan were assessed for incident cancers in 15 large parallel long-term multicenter double-blind clinical trials of these agents involving 138 769 participants.Patients and methods Individuals at high CVD risk were randomized to telmisartan (three trials, n=51 878), irbesartan (three trials, n=14 859), valsartan (four trials, n=44 264), candesartan (four trials, n=18 566), and losartan (one trial, n=9193) and followed for 23-60 months. Incident cancer cases were compared in patients randomized to ARBs versus controls. In five trials (n=42 403), the ARBs were compared to ACEi and in 11 trials (n=63 313) to controls without ACEi. In addition, in seven trials (n=47 020), the effect of ARBs with ACEi was compared to ACEi alone and in two trials ARBs with ACEi versus ARB alone (n=25 712).Results Overall, there was no excess of cancer incidence with ARB therapy compared to controls in the 15 trials [ 4549 (6.16%) cases of 73 808 allocated to ARB versus 3856 (6.31%) of 61 106 assigned to non-ARB controls; odds ratio (OR) 1.00, 95% confidence interval (CI) 0.95-1.04] overall or when individual ARBs were examined. ORs comparing combination therapy with ARB along with ACEi versus ACEi was 1.01 (95% CI 0.94-1.10), combination versus ARB alone 1.02 (95% CI 0.91-1.13), ARB alone versus ACEi alone 1.06 (95% CI 0.97-1.16) and ARB versus placebo/control without ACEi 0.97 (95% CI 0.91-1.04). There was no excess of lung, prostate or breast cancer, or overall cancer deaths associated with ARB treatment.Conclusion There was no significant increase in the overall or site-specific cancer risk from ARBs compared to controls.
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Sleight, Peter
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Gao, Peggy
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Yusuf, Salim
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Connolly, Stuart
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Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Center for Cardiovascular and Metabolic Research (CMR)(Swepub:gu)xsweka
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Pfeffer, Marc A.
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Granger, Christopher B.
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McMurray, John J. V.
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Sjoelie, Anne K.
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Massie, Barry M.
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Carson, Peter
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Lewis, Julia B.
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Wachtell, Kristian
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Dahlof, Bjorn
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Devereux, Richard B.
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Kjeldsen, Sverre E.
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Julius, Stevo
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Ibsen, Hans
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Lindholm, Lars H.Umeå universitet,Medicin(Swepub:umu)lali0003
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Olsen, Michael H.
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Okin, Peter M.
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Califf, Robert
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Holman, Rury R.
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Haffner, Steven M.
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Dagenais, Gilles
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Probstfield, Jeffrey
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Anderson, Craig
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Diaz, Rafael
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Dans, Antonio
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Levine, Mark
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Unger, Thomas
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Fagard, Robert
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Diener, Hans-Christoph
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Sacco, Ralph L.
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Zanchetti, Alberto
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Cohn, Jay N.
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Weber, Michael
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Solomon, SD
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Velazquez, EJ
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Göteborgs universitetCenter for Cardiovascular and Metabolic Research (CMR)
(creator_code:org_t)
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Teo, Koon K.
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Sleight, Peter
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Gao, Peggy
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Yusuf, Salim
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Connolly, Stuart
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Pfeffer, Marc A.
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McMurray, John J ...
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Sjoelie, Anne K.
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Massie, Barry M.
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Carson, Peter
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Lewis, Julia B.
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Wachtell, Kristi ...
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Dahlof, Bjorn
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Devereux, Richar ...
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Kjeldsen, Sverre ...
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Julius, Stevo
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Ibsen, Hans
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Lindholm, Lars H ...
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Olsen, Michael H ...
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Okin, Peter M.
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Califf, Robert
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Holman, Rury R.
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Haffner, Steven ...
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Dagenais, Gilles
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Probstfield, Jef ...
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Anderson, Craig
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Diaz, Rafael
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Dans, Antonio
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Levine, Mark
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Unger, Thomas
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Fagard, Robert
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Diener, Hans-Chr ...
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Sacco, Ralph L.
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Zanchetti, Alber ...
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Cohn, Jay N.
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Weber, Michael
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Solomon, SD
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Velazquez, EJ
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