[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-349465-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-349465-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","the-medical-impact-of-emergent-banning-of-n-nitrosodimethylamine-contaminated-antihypertensive-drug","The medical impact of emergent banning of N-nitrosodimethylamine contaminated antihypertensive drug","","Concerns surround the carcinogenic potential of N-nitrosodimethylamine (NDMA) when it contaminates the antihypertensive medication valsartan. A nationwide longitudinal observational cohort was used to assess whether NDMA-contaminated valsartan influences cancer incidence and related mortality. The study evaluated primary any-cancer outcomes, 12 organ-specific cancers, and all-cause and cardiovascular death risk before and after emergent withdrawal policies.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-medical-impact-of-emergent-banning-of-n-nitrosodimethylamine-contaminated-antihypertensive-drug/349465/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-medical-impact-of-emergent-banning-of-n-nitrosodimethylamine-contaminated-antihypertensive-drug/349465.png","ImageObject",300,407,{"name":42,"@type":43},"Anna Hans","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-25","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What question does the study investigate about NDMA and valsartan?","Question",{"text":62,"@type":63},"It evaluates whether NDMA-contaminated valsartan is associated with cancer incidence.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How was exposure and comparison handled in the study design?",{"text":67,"@type":63},"Participants were followed in a nationwide cohort and grouped using 1:1:1 propensity score matching across NDMA-uncontaminated, NDMA-contaminated, and initially suspended-but-confirmed-uncontaminated valsartan users.",{"name":69,"@type":60,"acceptedAnswer":70},"What were the main findings regarding cancer risk and deaths?",{"text":71,"@type":63},"NDMA exposure was associated with a modest increase in overall cancer risk, while all-cause and cardiovascular mortality did not differ significantly before versus after emergent banning; prostate cancer risk increased significantly.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},349465,1790211854,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},7,"Healthcare",40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},8,30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","ORIGINAL ARTICLE  \nKorean J Intern Med 2026;41 :676-689 [https://doi.org/10.3904/kj](https://doi.org/10.3904/kj)im.2026.023  \nThe medical impact of emergent banning of N-nitrosodimethylamine: contaminated antihypertensive drug  \nJuhee Ahn1,2,3,*, Sungho Won2,3,4,5,*, Jong-Heon Park6,7, and Hae-Young Lee8,9  \n1Division of Data Science, College of Intelligent Software Convergence, University of Suwon, Suwon; 2Department of Public Health Sciences, Seoul National University, Seoul; 3Institute of Health and Environment, Seoul National University, Seoul; 4 RexSoft Inc., Seoul; 5Interdisciplinary Program for Bioinformatics, College of Natural Sciences, Seoul National University, Seoul; 6National Health Insurance Service, Wonju; 7Department of Benefits Strategy, National Health Insurance Service, Wonju; 8 Department of Internal Medicine, Seoul National University College of Medicine, Seoul; 9 Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea  \n*These authors contributed equally to this manuscript.  \nBackground/Aims: Concerns exist regarding the potential carcinogenic effect of N-nitrosodimethylamine (NDMA) as a contaminant of the antihypertensive medication, valsartan. This study evaluated the association of NDMA-contaminated valsartan with cancer incidence.  \nMethods: Nationwide longitudinal observational cohort of 3,231,212 participants from the National Health Insurance Ser-  \nCopyright © 2026 The Korean Association of Internal Medicine  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \npISSN 1226-3303 eISSN 2005-6648 [http://www.kj](http://www.kj)[im.org](im.org)  \nAhn J, et al. NDMA-contaminated valsartan and cancer  \nvice of South Korea consisted and was followed up more than 7 years. We performed 1:1:1 pairwise propensity score matching (PSM) of NDMA-uncontaminated, NDMA-contaminated, and initially-suspended-but-finally confirmed as NDMA-uncontaminated valsartan user-groups. The primary outcome was any primary cancer incidence. The secondary outcome was the incidences of 12 organ-specific cancers. The risks of all-cause and cardiovascular deaths were estimated before and after the withdrawal of valsartan.  \nResults: Among participants (59 .5 ± 13.1 yr; male, 53. 5%), valsartan new users had adjusted hazard ratios and 95% confidence intervals of 1.069 (1.054–1.085) and 1.172 (1.128–1.216) for any cancer in the NDMA-exposed period (versus NDMA-unexposed) before and after PSM, respectively. Regardless of PSM, prostate cancer risk increased significantly. All-cause and cardiovascular mortality did not differ significantly with NDMA exposure before and after emergent banning. Conclusions: Use of valsartan products contaminated with NDMA was associated with a modestly increased risk of overall cancer compared with uncontaminated products, a finding that requires confirmation in further studies.  \nKeywords: Valsartan; N-nitrosodimethylamine; Death; Cancer  \nINTRODUCTION  \nPharmacological treatment of non-communicable diseases requires long-term use. Therefore, it is an existential threat that even a very small amount of carcinogen causes substantial problems through long-term accumulation. Hence, concerns about the possibility of cancer associated with antihypertensive drugs are continuously raised and resolved. Representative controversies have occurred with antihypertensive medications and overall cancers [1], angiotensin receptor blockers and lung cancer [2], nifedipine with breast and gastrointestinal tract cancers [3-5], and hydrochlorothiazide and skin cancer [6] .  \nRecent concerns include the potential carcinogenic effect of impurities generated during manufacturing processes rather than the m","cbCaiqXDLqfZvBik","https://ap.wps.com/l/cbCaiqXDLqfZvBik","pdf",1142700,41,"English","# Background/Aims\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Regulatory actions and prior evidence\n## Rationale for the current study","[{\"question\":\"What question does the study investigate about NDMA and valsartan?\",\"answer\":\"It evaluates whether NDMA-contaminated valsartan is associated with cancer incidence.\"},{\"question\":\"How was exposure and comparison handled in the study design?\",\"answer\":\"Participants were followed in a nationwide cohort and grouped using 1:1:1 propensity score matching across NDMA-uncontaminated, NDMA-contaminated, and initially suspended-but-confirmed-uncontaminated valsartan users.\"},{\"question\":\"What were the main findings regarding cancer risk and deaths?\",\"answer\":\"NDMA exposure was associated with a modest increase in overall cancer risk, while all-cause and cardiovascular mortality did not differ significantly before versus after emergent banning; prostate cancer risk increased significantly.\"}]","The medical impact of emergent banning of N-nitrosodimethylamine contaminated antihypertensive drug | PDF",1790083424,103]