ACE inhibitors may slow cognitive decline

METHODOLOGY

Retrospective cohort study using electronic health records from a healthcare organization in Israel analyzed cancer incidence among adults with hypertension (53.0% women) who were treated exclusively with ACEIs or ARBs; all participants were free of cancer as of January 1, 2000.
A total of 346,405 exclusive ACEI users and 77,018 exclusive ARB users were included after excluding patients who switched between medication classes or were noncompliant with therapy.
Mean treatment duration was 10.2 years among ACEI users and 9.5 years among ARB users, with mean age at treatment initiation of 66.8 years for ACEI users and 68.7 years for ARB users.
Active cancer follow-up spanned from January 2002 through December 2024, allowing for a 2-year exposure window, with up to 23 years of observation.
Primary outcome was diagnosis of any cancer; secondary outcomes included the 10 most prevalent cancer types diagnosed during follow-up.

ACEI therapy was associated with lower overall odds of cancer compared with ARB therapy (odds ratio [OR], 0.851; 95% CI, 0.838-0.865).
The odds of breast cancer (OR, 0.830), prostate cancer (OR, 0.841), melanoma (OR, 0.736), non-Hodgkin lymphoma (OR, 0.877), kidney cancer (OR, 0.893), and colorectal cancer (OR, 0.878; P < .05 for all) were lower among ACEI users than among ARB users.
The odds of lung cancer (OR, 1.136), bladder cancer (OR, 1.226), and pancreatic cancer (OR, 1.140; P < .05 for all) were higher among ACEI users than among ARB users.
The risk for leukemia was not significantly different among the groups.

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