Renin-angiotensin system inhibitors improve survival in patients with cholangiocarcinoma (CCA) and concurrent hypertension, according to a new study published in BMC Cancer.

This finding is important because it suggests that antihypertensive medications may have a positive effect on the prognosis of CCA, the researchers noted. 

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It is already known that hypertension is a risk factor for CCA. Here, a team of researchers from China conducted a retrospective study on 102 patients with concurrent CCA and hypertension who were treated with radical surgery. The median follow-up was 36.7 months.

Statistical analyses showed that the use of renin-angiotensin system inhibitors was a protective factor for progression-free and overall survival in patients with CCA and hypertension. 

The researchers compared 28 patients who were using renin-angiotensin system inhibitors and 56 patients who were not. 

They found that the median progression-free survival of the users was longer, with 17.6 months compared to 10.5 months for nonusers. Similarly, the overall survival of users was longer at 24.8 months compared to 14.6 months for nonusers.  

The 1-year, 2-year, and 3-year survival rates of patients using renin-angiotensin system inhibitors were also higher than those not using the medications, with 89.1%, 77.0%, and 65.5%, respectively, compared to 70.9%, 54.0%, and 40.0%, respectively.

The researchers found no association between the use of calcium channel blockers, diuretics, and β-blockers and survival. 

They concluded that renin-angiotensin system inhibitors had a positive effect on the survival of patients with CCA and hypertension. 

However, they drew attention to some severe limitations of their study, such as its retrospective nature, which may be associated with selection bias, and the fact that it is a small, single-center study. They said that“ large-scale prospective multicenter studies, ideally randomized controlled trials, are still warranted to verify the conclusion.”

CCA is a heterogeneous group of biliary malignancies that are highly fatal.


Zhu XX, Li JH, Fang P, et al. Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: A propensity score-matched cohort study. BMC Cancer. Published online September 5, 2023. doi:10.1186/s12885-023-11152-2