Is angiotensin-converting enzyme inhibitors/angiotensin receptor blockers therapy protective against prostate cancer?
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Yeqing Mao1, Xin Xu1, Xiao Wang1, Xiangyi Zheng1 and Liping Xie1
1 Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Yeqing Mao, email:
Xin Xu, email:
Keywords: angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, prostate cancer, meta-analysis, cohort
Received: September 09, 2015 Accepted: January 01, 2016 Published: January 07, 2016
Emerging evidence suggests that renin-angiotensin system (RAS) may act as a molecular and therapeutic target for treating site-specific cancers, including prostate cancer. However, previous observational studies regarding the association between RAS inhibitors and prostate cancer risk have reported inconsistent results. We examined this association by performing a systematic review and meta-analysis. A total of 20,267 patients from nine cohort studies were enrolled. Compared with non-users of RAS inhibitors, individuals using RAS inhibitors had a reduced risk of prostate cancer (RR 0.92, 95 % CI 0.87-0.98), without statistically significant heterogeneity among studies (P = 0.118 for heterogeneity, I2 = 37.6 %). In addition, when subgroup analyses by study quality and number of cases, more statistically significant associations were observed in studies of high quality (RR 0.93, 95 % CI 0.88-0.97) and large sample size (RR 0.94, 95 % CI 0.91-0.98). There was no evidence of significant publication bias with Begg’s test (P = 0.602) or with Egger’s test (P = 0.350). Overall, this study indicates that use of RAS inhibitors may be associated with a decreased risk of prostate cancer. Large-scale well designed studies are needed to further explore this association.
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