Trending Clinical Topics for November 2018

Ryan Syrek

Disclosures

November 30, 2018

Trending Clinical Topic of the Week (November 3-9): ACE Inhibitors

A study that found a worrisome association, new guidance for disease treatment among younger patients, and medication behaviors in pregnant women resulted in this week's top clinical topic. A recent large, population-based cohort study found that the use of angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure was associated with an increased risk of developing lung cancer. Given the widespread use of ACE inhibitors to treat patients with hypertension, this association may mean that a large number of patients are at risk. The analysis of almost 1 million patients found that those who took ACE inhibitors for more than 5 years were at increased risk for lung cancer compared with those who took angiotensin-receptor blockers (ARBs), but those who used ACE inhibitors for less than 5 years were not at increased risk.

ACE inhibitors were also included in a recent guideline released by the International Society for Pediatric and Adolescent Diabetes (ISPAD). The drugs are recommended for use in children with diabetes and hypertension, as they were proven safe in short-term studies. Meanwhile, new data revealed that many women with chronic hypertension stop taking antihypertensive medications, including ACE inhibitors, when they become pregnant. The study found that many women never filled prescriptions for antihypertensive medications during pregnancy, even those with evidence of poorly controlled blood pressure. Researchers suggest that additional studies are needed to understand the impact of this finding on women's long-term health. Given the popularity of this week's top trending clinical topic, many will be eagerly awaiting further findings.

For more on ACE inhibitor dosing, read here.

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