PLoS Medicine (Feb 2022)

Genetically proxied therapeutic inhibition of antihypertensive drug targets and risk of common cancers: A mendelian randomization analysis.

  • James Yarmolinsky,
  • Virginia Díez-Obrero,
  • Tom G Richardson,
  • Marie Pigeyre,
  • Jennifer Sjaarda,
  • Guillaume Paré,
  • Venexia M Walker,
  • Emma E Vincent,
  • Vanessa Y Tan,
  • Mireia Obón-Santacana,
  • Demetrius Albanes,
  • Jochen Hampe,
  • Andrea Gsur,
  • Heather Hampel,
  • Rish K Pai,
  • Mark Jenkins,
  • Steven Gallinger,
  • Graham Casey,
  • Wei Zheng,
  • Christopher I Amos,
  • International Lung Cancer Consortium,
  • PRACTICAL consortium,
  • MEGASTROKE consortium,
  • George Davey Smith,
  • Richard M Martin,
  • Victor Moreno

DOI
https://doi.org/10.1371/journal.pmed.1003897
Journal volume & issue
Vol. 19, no. 2
p. e1003897

Abstract

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BackgroundEpidemiological studies have reported conflicting findings on the potential adverse effects of long-term antihypertensive medication use on cancer risk. Naturally occurring variation in genes encoding antihypertensive drug targets can be used as proxies for these targets to examine the effect of their long-term therapeutic inhibition on disease outcomes.Methods and findingsWe performed a mendelian randomization analysis to examine the association between genetically proxied inhibition of 3 antihypertensive drug targets and risk of 4 common cancers (breast, colorectal, lung, and prostate). Single-nucleotide polymorphisms (SNPs) in ACE, ADRB1, and SLC12A3 associated (P ConclusionsIn this study, we observed that genetically proxied long-term ACE inhibition was associated with an increased risk of colorectal cancer, warranting comprehensive evaluation of the safety profiles of ACE inhibitors in clinical trials with adequate follow-up. There was little evidence to support associations across other drug target-cancer risk analyses, consistent with findings from short-term randomized controlled trials for these medications.