A population based cohort study in the UK showed that the use of angiotensin converting enzyme inhibitors (ACEIs) was associated with an increased risk of lung cancer. The association was particularly elevated among people using ACEIs for more than five years. The cohort of 992 061 patients newly treated with antihypertensive drugs between 1 January 1995 and 31 December 2015 was followed for a mean of 6.4 years. There were 7952 incident lung cancer events (crude incidence 1.3 per 1000 person years). Overall, use of ACEIs was associated with an increased risk of lung cancer (incidence rate 1.6 v 1.2 per 1000 person years; hazard ratio [HR] 1.14), compared with use of angiotensin receptor blockers. HRs gradually increased with longer durations of use, with an association evident after five years of use (HR 1.22) and peaking after more than 10 years of use (1.31). Similar findings were observed with time since initiation. Previous biological evidence suggested that ACEIs may increase the risk of lung cancer through the accumulation of bradykinin and substance P in lungs. However, ACEIs are effective in cardiovascular diseases. Source: https://www.bmj.com/
