The associations of hypertension medication with lung cancer risk and related mortality

초록

Background and Aims The aim of this study was to investigate the associations of hypertension medication, especially calcium-channel blocker (CCB), angiotensin converting enzyme inhibitor (ACEI), or angiotensin II receptor blocker(ARB) with lung cancer risk and mortality using population-based nationwide cohort data. Methods This study included a total of 3,718,905 participants who underwent a national health check-up from 2010to 2019. Lung cancer incidence and mortality were identified using a registered lung cancer diagnosis code (International Classification of Diseases, 10th revision, code C34) and the Korean National Death Registry. Patients who took combination hypertensive drugs were excluded, and patients with drug change between different drug groups were also excluded. Patients who took one drug for more than 3 months were defined as taking antihypertensive drugs. Results There were 461,967 people in the ARB group(ACEi or ARB) and 199,227 people in the CCB group. ACEior ARB use had a protective association with lung cancer incidence (p-value=0.0043) and all-cause mortality (p-value < 0.0001) than CCB group. Sub-group analysis showed that ARB was effective for males, BMI < 25, and smoking history group. For correction of baseline characteristics, we conducted propensity score matching. After matching, ACEior ARB use also had a protective association with lung cancer incidence (p-value=0.0103) and all-cause mortality (p-value < 0.0001). Conclusions Among antihypertensive drugs, the use of ACEi or ARB rather than CCB is thought to lower the incidence of lung cancer.