Blood pressure medicines valsartan and losartan may lead to cancer, says study

In India losartan, telmisartan and valsartan are marketed by several companies including Dr Reddy’s, Glenmark Pharma, Lupin Ltd, Torrent Pharma, Alkem labs, Unichem, Intas Pharma, USV Ltd, Aristo Pharma, Piramal Healthcare and Emcure  Pharma, under different brand names such as  Diovan, Valent, Telsartan, Valzaar, Candesar, Candelong, Candez, Candar, Dilsave, Telma, Starval, Tazloc, Telista, Telsar, Sartel, Telvas, Arbitel (Micro Pharma), Telpres etc.

Some of the commonly used drugs to treat blood pressure medicines containing drugs  including losartan, candesartan, telmisartan and valsartan could lead to cancer, according to a new study.

These drugs belonging to the class of angiotensin-receptor blockers may elevate the risk of new cancer upto 8% in patients who consume the pills.

Angiotensin-receptor blockers are currently used by over 82 million people in 2009, according to IMS Health Inc.

Angiotensin-receptor blockers like valsartan and telmisartan reduce the risk of stroke and the risk of death from left ventricular dysfunction after heart attack, they slow progression in chronic kidney disease, and they improve outcomes in heart failure.

Currently, US FDA is evaluating data from two clinical trials in which patients with type 2 diabetes taking olmesartan (Benicar) had a higher rate of death from a cardiovascular cause compared to patients taking a placebo.

In a meta-analysis of nine published studies, angiotensin-receptor blockers were associated with a modest but statistically significant 8% increase in the relative risk of a new cancer, according to Ilke Sipahi, MD, and colleagues at Case Western Reserve University School of Medicine in Cleveland.

The result of a 2003 trial using of one of the drugs, which showed an unexpected increase in the proportion of fatal cancers among those getting the medication, triggered the research.

Sipahi and colleagues searched literature from five trials with data on the occurrence of new cancers in a total of 61,590 patients. Five trials had data on specific solid tumors and eight trials had data on cancer-related deaths.

Nine clinical studies were included in the analysis, with a total of 94,210 patients, they reported. The studies included data on four of the seven available angiotensin-receptor blockers – losartan (Cozaar), candesartan (Atacand), telmisartan (Micardis), and valsartan (Diovan).

30,014 patients (or 85.7% of those in the five studies with data on the issue) were treated with telmisartan, the researchers said.

Analysis showed that the meta-analytic relative risk of a new cancer in those five trials was 1.08, with a 95% confidence interval from 1.01 to 1.15, which was significant. The absolute risk increase was 1.2% over four years, which should be put in the context of an estimated 41% lifetime risk of cancer.

Doctors should explain to interested patients that this meta-analysis found a link between angiotensin-receptor blockers and the incidence of new cancers, the reserachers said while cautioning that further study is needed.

Patients should consider substituting angiotensin-converting enzyme inhibitors when prescribing for hypertension.

In India losartan, telmisartan and valsartan are marketed by several companies including Dr Reddy’s, Glenmark Pharma, Lupin Ltd, Torrent Pharma, Alkem labs, Unichem, Intas Pharma, USV Ltd, Aristo Pharma, Piramal Healthcare, under different brand names such as  Diovan, Valent, Telsartan, Valzaar, Telma, Starval, Tazloc, Telista, Telsar, Sartel, Telvas, Arbitel (Micro Pharma), Telpres etc.