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  • Teo, Koon K. (author)

Effects of telmisartan, irbesartan, valsartan, candesartan, and losartan on cancers in 15 trials enrolling 138 769 individuals The ARB Trialists Collaboration

  • Article/chapterEnglish2011

Publisher, publication year, extent ...

  • 2011
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-104472
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-104472URI
  • https://doi.org/10.1097/HJH.0b013e328344a7deDOI
  • https://gup.ub.gu.se/publication/273429URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:for swepub-publicationtype

Notes

  • 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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Added entries (persons, corporate bodies, meetings, titles ...)

  • Sleight, Peter (author)
  • Gao, Peggy (author)
  • Yusuf, Salim (author)
  • Connolly, Stuart (author)
  • Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Center for Cardiovascular and Metabolic Research (CMR)(Swepub:gu)xsweka (author)
  • Pfeffer, Marc A. (author)
  • Granger, Christopher B. (author)
  • McMurray, John J. V. (author)
  • Sjoelie, Anne K. (author)
  • Massie, Barry M. (author)
  • Carson, Peter (author)
  • Lewis, Julia B. (author)
  • Wachtell, Kristian (author)
  • Dahlof, Bjorn (author)
  • Devereux, Richard B. (author)
  • Kjeldsen, Sverre E. (author)
  • Julius, Stevo (author)
  • Ibsen, Hans (author)
  • Lindholm, Lars H.Umeå universitet,Medicin(Swepub:umu)lali0003 (author)
  • Olsen, Michael H. (author)
  • Okin, Peter M. (author)
  • Califf, Robert (author)
  • Holman, Rury R. (author)
  • Haffner, Steven M. (author)
  • Dagenais, Gilles (author)
  • Probstfield, Jeffrey (author)
  • Anderson, Craig (author)
  • Diaz, Rafael (author)
  • Dans, Antonio (author)
  • Levine, Mark (author)
  • Unger, Thomas (author)
  • Fagard, Robert (author)
  • Diener, Hans-Christoph (author)
  • Sacco, Ralph L. (author)
  • Zanchetti, Alberto (author)
  • Cohn, Jay N. (author)
  • Weber, Michael (author)
  • Solomon, SD (author)
  • Velazquez, EJ (author)
  • Göteborgs universitetCenter for Cardiovascular and Metabolic Research (CMR) (creator_code:org_t)

Related titles

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