Background Angiotensin converting enzyme inhibitors (angiotensin converting enzyme inhibitor, ACEI) and angiotensin receptor inhibitors (angiotensin, ARB) are currently widely used in hypertension treatment. It is also reported that ACEI/ARB might have the potential effect in anti-tumour treatment, but its clinical effects on the prognosis of tumour patients are unclear.

Purpose This study was carried out to explore the effect of ACEI/ARB on first-line chemotherapy curative effect and the influence of survival in patients with advanced gastric malignant tumour combined with high blood pressure.

Material and methods Information of histologically confirmed advanced gastric cancer patients combined with high blood pressure who received at least two cycles containing fluorouracil first-line chemotherapy drugs from 1 January 2009 to 31 December 2012 in our hospital were collected and analysed, and further telephone follow-up was carried out. The SPSS software version 20.0 was used for all analyses. Student’s t test was used to compare mean figures, other data were assessed by the Chi square test.

Results A total of 124 patients were enrolled in this study, including the ACEI/ARB group (23 cases) and control group with patients treated by other antihypertensive agents (101 cases). There was no obvious difference in basic information and the period of chemotherapy, pathological type, tumour site, number of metastasis lymph nodes, TNM staging, tumour marker level and other therapy including patients receiving second- and third-line chemotherapy between the two groups were similar. The response rate of first-line chemotherapy were 73.9% (17) and 41.6% (42) in ACEI/ARBs group and non-ACEI/ARBs group, respectively (p=0.016). The median survival time of the ACEI/ARBs group was 669 days, and was 410 in the non- and ACEI/ARBs groups, but there was a significant difference in the total survival between the two groups (p=0.01). The results of COX regression analysis (including sex, PS score, smoking, drinking, pathological type, tumour site, number of metastasis lymph nodes, TNM staging, first-line chemotherapy and other treatment) showed that first-line chemotherapy had an effect on the survival of patients with different antihypertensive drugs (p=0.001).

Conclusion Compared with other antihypertensive drugs, the benefit of first-line chemotherapy efficacy and total survival improvement in the ACEI/ARB group is obvious. Forward-looking large-sample research is required.

No conflict of interest