Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study

Abstract Background Chronic obstructive pulmonary disease (COPD) is one of the most prevalent specific chronic respiratory diseases. It could worsen the development of cardiovascular diseases (CVD) and lung cancer. We aimed to elucidate the relationship between the use of angiotensin receptor blocke...

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Main Authors: Wenhao Li, Qingqing Yang, Yahong Chen, Yexiang Sun, Peng Shen, Feng Sun, Jinzhu Jia
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03248-z
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author Wenhao Li
Qingqing Yang
Yahong Chen
Yexiang Sun
Peng Shen
Feng Sun
Jinzhu Jia
author_facet Wenhao Li
Qingqing Yang
Yahong Chen
Yexiang Sun
Peng Shen
Feng Sun
Jinzhu Jia
author_sort Wenhao Li
collection DOAJ
description Abstract Background Chronic obstructive pulmonary disease (COPD) is one of the most prevalent specific chronic respiratory diseases. It could worsen the development of cardiovascular diseases (CVD) and lung cancer. We aimed to elucidate the relationship between the use of angiotensin receptor blockers (ARBs) and the incidence of lung cancer among the COPD population in China. Methods This retrospective cohort included COPD patients identified by the international classification of diseases 10th edition (ICD-10) codes in the Yinzhou Regional Health Care Database. The use of ARBs was defined according to the use and cumulative use. The lung cancer was defined by ICD-10 code (up to 2023). Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the use of ARBs on the risk of lung cancer. Results This population-based COPD cohort comprised 25,436 patients with an average age of 68.2 years (standard deviation [SD]: 12.59 years), of which 60.6% were male. A total of 8,611 patients received at least one prescription for ARBs. After adjusting for multiple covariates, the results showed that cumulative annual exposure to ARBs was associated with a reduced risk of lung cancer (HR: 0.93, 95% CI: 0.90–0.97). The results of sensitivity analyses and negative control exposure analyses indicated that the associations were largely consistent and less likely to be influenced by unobserved confounding. Conclusions The use of ARBs may reduce the risk of lung cancer among patients with COPD.
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spelling doaj-art-95396dbd760d483ea40d15c05cd42b7b2025-08-20T03:07:51ZengBMCRespiratory Research1465-993X2025-05-0126111010.1186/s12931-025-03248-zAngiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort studyWenhao Li0Qingqing Yang1Yahong Chen2Yexiang Sun3Peng Shen4Feng Sun5Jinzhu Jia6Department of Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology and Biostatistics, School of Public Health, Peking UniversityDepartment of Pulmonary and Critical Care Medicine, Peking University Third HospitalYinzhou District Center for Disease Control and PreventionYinzhou District Center for Disease Control and PreventionDepartment of Epidemiology and Biostatistics, School of Public Health, Peking UniversityDepartment of Biostatistics, School of Public Health, Peking UniversityAbstract Background Chronic obstructive pulmonary disease (COPD) is one of the most prevalent specific chronic respiratory diseases. It could worsen the development of cardiovascular diseases (CVD) and lung cancer. We aimed to elucidate the relationship between the use of angiotensin receptor blockers (ARBs) and the incidence of lung cancer among the COPD population in China. Methods This retrospective cohort included COPD patients identified by the international classification of diseases 10th edition (ICD-10) codes in the Yinzhou Regional Health Care Database. The use of ARBs was defined according to the use and cumulative use. The lung cancer was defined by ICD-10 code (up to 2023). Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the use of ARBs on the risk of lung cancer. Results This population-based COPD cohort comprised 25,436 patients with an average age of 68.2 years (standard deviation [SD]: 12.59 years), of which 60.6% were male. A total of 8,611 patients received at least one prescription for ARBs. After adjusting for multiple covariates, the results showed that cumulative annual exposure to ARBs was associated with a reduced risk of lung cancer (HR: 0.93, 95% CI: 0.90–0.97). The results of sensitivity analyses and negative control exposure analyses indicated that the associations were largely consistent and less likely to be influenced by unobserved confounding. Conclusions The use of ARBs may reduce the risk of lung cancer among patients with COPD.https://doi.org/10.1186/s12931-025-03248-zAngiotensin receptor blockersLung cancerChronic obstructive pulmonary diseaseCohort study
spellingShingle Wenhao Li
Qingqing Yang
Yahong Chen
Yexiang Sun
Peng Shen
Feng Sun
Jinzhu Jia
Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
Respiratory Research
Angiotensin receptor blockers
Lung cancer
Chronic obstructive pulmonary disease
Cohort study
title Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
title_full Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
title_fullStr Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
title_full_unstemmed Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
title_short Angiotensin receptor blockers use and lung cancer risk in Chinese patients with chronic obstructive pulmonary disease: a population-based cohort study
title_sort angiotensin receptor blockers use and lung cancer risk in chinese patients with chronic obstructive pulmonary disease a population based cohort study
topic Angiotensin receptor blockers
Lung cancer
Chronic obstructive pulmonary disease
Cohort study
url https://doi.org/10.1186/s12931-025-03248-z
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