My Mother's Cardiologist Recently Took Her Off Of Lisinopril Due

Posted on Mon, 26 Nov 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 26 Nov 2018 Answered on

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Question : My mother's cardiologist recently took her off of lisinopril due to a study that showed it has the potential to cause lung cancer. He wants to put her on valsartan, but I know that drug has recently been recalled as well due to cancer concerns. My question is do you think an ace inhibitor or arb is necessary as she is currently on a beta blocker? She does have diastolic heart failure, enlarged heart, afib , and diabetes. However, her ejection fraction is normal at 55-60%. If so, what do you think is a safe alternative drug or even natural remedy, if any? Finally, her diabetes has been elevated ac1, 8.2. Her doctor wants to put her on juniva in addition to what she is currently taking, glipizide. Again, I read that juniva has potential to cause pancreatic cancer. Do you know of a safer alternative? Thank you.

Answered by Dr. Ilir Sharka (1 hour later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that considering the fact that she suffers from heart failure, even though her ejection fraction is preserved, an ACEI or ARB is necessary, because they can help improve heart failure.

You should know that ACEI and ARB usually act on blood pressure values, by lowering it and in the peripheral resistance.

While betablockers, usually act mainly on the heart rate by lowering it. They have a week anti-hypertensive effects.

Both betablockers and ACEI (or ARBs) are usually used in heart failure.

Regarding the risk of cancer related to these drugs, I would explain that it is not a matter of concern, compared to the benefits of these drugs.

For this reason, I would not recommend avoiding them, especially in case the kidney function is good.

You should know that lisinopril may cause chronic cough as a possible adverse effect. Maybe that is the reason why her doctor is switching her from lisinopril to valsartan (ARBs do not cause cough, and have a similar mechanism of action compared to ACEIs).

Regarding Januvia, I agree with you that it may lead to potential adverse effects like pancreatitis or pancreatic cancer.

You should discuss with her doctor on this issue. Another possible treatment option would be insulin, which has a lot of benefits to the heart and brain.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (22 minutes later)

The cardiologist is the one that recommended taking her off of the lisinopril due to lung cancer study. We hadn't even heard of the study at that time. As far as arbs go, which one do you recommend when it comes to both safety and effectiveness?

Answered by Dr. Ilir Sharka (15 hours later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Coming to this point, I would recommend taking telmisartan or olmesartan, which is well tolerated with less adverse effects and high efficacy.

You should discuss with your doctor on the above treatment options!

Wishing all the best,

Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar