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Ramipril & Cancer?

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  • Ramipril & Cancer?

    New Bale Doneen Doctor just issued me an Rx for Ramipril 5 mg BID.
    I have plaque mainly in 1 coronary artery at a high level although my CIMT score was very good, got an Artery age of 30 years old
    and I am 51. I have borderline high BP. Also on Crestor 5 QOD and Niacin where I am slowly being titrated to 2000 mg QD (at 500 mg now).
    Taking niacin because LPa.
    Anyway, question right now is concerning Ramipril.
    I am reading there can be a link with ACE's and mainly LUNG cancer, Coly How :-O?
    Is this overblown? I read article saying it increases your cancer risk increases 10-14% or something to that affect from Ramipril.
    Any commentary regarding this either way?

    Thanks

  • #2
    Since nobody has made a comment yet, I will give you my thoughts. The issue is lack of risk analysis when you generally only get a risk increase from a statement/article. Dr. Brewer did a risk analysis for when he recommends statins to his patients, and the logic is the same for most issues; whether the good outweighs the potential bad. The one article that I read a while back when I first saw your topic explained the risk increase elements, but the last sentence said something to the effect that the reader should make no changes based upon that article. I had to chuckle at that sentence. I take ramapril, and I am going to continue to take ramapril way past the five year mark. Why? Two reasons, let me explain further.

    The overall risk for me to get lung cancer is very low. The increase in overall risk for a 10-14% increase is still very low. Are there circumstances for which I would have an overall much higher risk to start with before considering ramapril? If I had long-term exposure to a lot of cigarette or other smoke products, radon, asbestos, severe pollution, a lot of ionizing radiation from whatever medical procedures, or had a lot of lung cancer in my family then a 10-14% increase would make for a much higher overall risk.

    So let's compare that overall slight increase in risk to the downside of stopping an ACE inhibitor like ramapril. I have a significant risk for cardiovascular disease with a CAC score in the 200's and one higher risk discrete plaque shown on a CIMT test. Ramapril lowers cardiovascular inflammation which is one of the main drivers for cardiovascular disease. To me, the choice is obvious. Everyone with their doctor should do these kinds of evaluations. In the end, it is all about risk analysis and risk management.
    Last edited by Tom; 10-09-2019, 12:45 AM.

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    • #3
      Tom,
      TY for your response and yes makes good sense.

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