The incidence and risk of biochemical recurrence following radical radiotherapy for prostate cancer in men on angiotensin-converting enzyme inhibitors (ACEIS) or angiotensin receptor blockers (ARB).

INTRODUCTION & OBJECTIVES: ACEIs/ARB decrease the risk of prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aim was to investigate the incidence and risk of BR in men on ACEIs/ARB after radical radiotherapy (RR) with adjuvant\neoadjuvant hormone treatment (HT).

MATERIAL & METHODS: A propensity score analysis of 514 men was conducted. Men were stratified into three groups: hypertensive on ACEIs/ARB (as a study group), non-hypertensive not on ACEIs/ARB and hypertensive not on ACEIs/ARB (both as control groups). Chisquare, Kruskal–Wallis, ANOVA, risk ratio, confidence interval, Kaplan–Meier plots and log-rank tests were used.

RESULTS: The mean age was 68.51 years, and the follow-up for the men was 3.33 years. There was a statistically significant difference in the prevalence of BR among the treatment groups (p<0.001). The incidence of BR was significantly lower in the hypertensive on ACEIs/ARB group than in the non-hypertensive not on ACEIs/ARB (p<0.001) or hypertensive not on ACEIs/ARB groups (p<0.009). The incidence of BR was significantly lower in the hypertensive not on ACEIs/ARB group than in the non-hypertensive not on ACEIs/ARB group (p<0.013). The risk ratio of BR in the hypertensive on ACEIs/ARB group was significantly lower than in the non-hypertensive not on ACEIs/ARB group (RR 0.74, 95% CI, 0.64–0.86, p<0.001) and the hypertensive not on ACEIs/ARB group (RR 0.78, 95% CL, 0.67–0.91, p<0.001). A time-to-event analysis revealed that the hypertensive on ACEIs/ARB group was significantly different compared to the control groups (p<0.031).

CONCLUSIONS: Men on ACEIs/ARB had a significantly lower incidence of BR after RR with HT. The intake of ACEIs/ARB was associated with a reduced risk of BR.