Abstract
The objective of this study was to determine the site-specific cancer incidence of hypertensive patients and examine the effect of blood pressure-related variables on the risk of cancers with elevated incidence among the hypertensive patients. A record linkage study of Hypertension Register of the North Karelia Project and the Finnish Cancer Registry was conducted. The mean follow-up time was 16 years. A total of 20 529 hypertensive patients were studied. Main outcome measures were standardised incidence ratios and hazard ratios. The overall cancer incidence was close to that of the general population for both men and women. The incidence rate for the kidney cancer was significantly increased in hypertensive patients (standardised incidence ratio 1.34, 95% confidence interval (CI) 1.11–1.60), as well as incidence rates for cancers of pancreas (1.26, 1.02–1.54), and endometrium (1.22, 1.01–1.44) in hypertensive women. The incidence of lung cancer was significantly decreased (0.86, 0.77–0.95). The incidence of liver cancer was elevated with borderline significance (1.36, 0.99–1.82). In Cox regression models, the use of antihypertensive drugs at baseline was a significant predictor of kidney (hazard ratio for use of antihypertensive drugs 1.89, 95% CI 0.96–3.75) and pancreatic cancer (1.78, 0.99–3.22) in women but not in men. The incidence of endometrial cancer or liver cancer was not related to blood pressure levels or the use of antihypertensive drugs. In women, obesity was a significant predictor of cancers of the endometrium, kidney and liver. In conclusion, increased occurrence of some cancer types among hypertensive patients seem to be partly explained by obesity and the use of antihypertensive drugs.
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References
Dyer AR et al. High blood-pressure: a risk factor for cancer mortality? Lancet 1975; 1: 1051–1056.
Svardsudd K, Tibblin G . Mortality and morbidity during 13.5 years’ follow-up in relation to blood pressure. The study of men born in 1913. Acta Med Scand 1979; 205: 483–492.
Raynor Jr WJ et al. High blood pressure and 17-year cancer mortality in the Western Electric Health Study. Am J Epidemiol 1981; 113: 371–377.
Khaw KT, Barrett-Connor E . Systolic blood pressure and cancer mortality in an elderly population. Am J Epidemiol 1984; 120: 550–558.
Goldbourt U et al. Elevated systolic blood pressure as a predictor of long-term cancer mortality: analysis by site and histologic subtype in 10,000 middle-aged and elderly men. J Natl Cancer Inst 1986; 77: 63–70.
Filipovsky J et al. Abdominal body mass distribution and elevated blood pressure are associated with increased risk of death from cardiovascular diseases and cancer in middle-aged men. The results of a 15- to 20-year follow-up in the Paris prospective study I. Int J Obes Relat Metab Disord 1993; 17: 197–203.
Rosengren A et al. Hypertension and long-term cancer incidence and mortality among Swedish men. J Hypertens 1998; 16: 933–940.
Wannamethee G, Shaper AG . Blood pressure and cancer in middle-aged British men. Int J Epidemiol 1996; 25: 22–31.
Peeters P et al. Hypertension, antihypertensive drugs, and mortality from cancer among women. J Hypertens 1998; 16: 941–947.
Taylor JO et al. Blood pressure and mortality risk in the elderly. Am J Epidemiol 1991; 134: 489–501.
Clausen J, Jensen G . Blood pressure and mortality: an epidemiological survey with 10 years follow-up. J Hum Hypertens 1992; 6: 53–59.
Grove JS et al. The association of blood pressure with cancer incidence in a prospective study. Am J Epidemiol 1991; 134: 942–947.
Batty GD, Shipley MJ, Marmot MG, Davey SG, Whitehall Study. Blood pressure and site-specific cancer mortality: evidence from the original Whitehall study. Br J Cancer 2003; 89: 1243–1247.
Shapiro JA et al. Hypertension, antihypertensive medication use, and risk of renal cell carcinoma. Am J Epidemiol 1999; 149: 521–530.
Chow WH et al. Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med 2000; 343: 1305–1311.
Parazzini F et al. Population attributable risk for endometrial cancer in northern Italy. Eur J Cancer Clin Oncol 1989; 25: 1451–1456.
Soler M et al. Hypertension and hormone-related neoplasms in women. Hypertension 1999; 34: 320–325.
Zhang ZF et al. Adenocarcinomas of the esophagus and gastric cardia: medical conditions, tobacco, alcohol, and socioeconomic factors. Cancer Epidemiol Biomarkers Prev 1996; 5: 761–768.
Grossman E, Messerli FH, Goldbourt U . Does diuretic therapy increase the risk of renal cell carcinoma? Am J Cardiol 1999; 83: 1090–1093.
Lindblad P et al. Risk of kidney cancer among patients using analgesics and diuretics: a population-based cohort study. Int J Cancer 1993; 55: 5–9.
Pahor M et al. Do calcium channel blockers increase the risk of cancer? Am J Hypertens 1996; 9: 695–699.
Lever AF et al. Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer? Lancet 1998; 352: 179–184.
Nissinen A, Tuomilehto J, Puska P . The hypertension register of the North Karelia project. Clin Sci Mol Med Suppl 1978; 4: 355s–358s.
Puska P et al. The North Karelia Project: 20 Years’ Results and Experience. Helsinki, Finland: National Public Health Institute, 1995.
Lindgren A, et al. Cancer incidence in hypertensive patients in North Karelia, Finland. Hypertension 2001; 37: 1251–1255.
Lindgren A et al. Blood pressure, smoking and the incidence of lung cancer in hypertensive men in North Karelia, Finland. Am J Epidemiol 2003; 158: 442–447.
World Health Organization. Arterial Hypertension: Report of a WHO Expert Committee. Geneva, Switzerland: World Health Organization, Technical Report Series 628, 1998.
Lindholm LH et al. Relation between drug treatment and cancer in hypertensives in the Swedish Trial in Old Patients with Hypertension 2: a 5-year, prospective, randomised, controlled trial. Lancet 2001; 358: 539–544.
Dyer AR, Elliott P . The INTERSALT study: relations of body mass index to blood pressure. INTERSALT Co-operative Research Group. J Hum Hypertens 1989; 3: 299–308.
Jalkanen L et al. Changes in body mass index in a Finnish population between 1972 and 1982. J Int Med 1989; 226: 163–170.
Yuan JM et al. Hypertension, obesity and their medications in relation to renal cell carcinoma. Br J Cancer 1998; 77: 1508–1513.
McLaughlin JK et al. International renal-cell cancer study. VIII. Role of diuretics, other anti-hypertensive medications and hypertension. Int J Cancer 1995; 63: 216–221.
Mellemgaard A et al. Risk factors for renal cell carcinoma in Denmark: role of medication and medical history. Int J Epidemiol 1994; 23: 923–930.
Muscat JE, Hoffmann D, Wynder EL . The epidemiology of renal cell carcinoma. A second look. Cancer 1995; 75: 2552–2557.
Mellemgaard A, Moller H, Olsen JH . Diuretics may increase risk of renal cell carcinoma. Cancer Causes Control 1992; 3: 309–312.
Gago-Dominguez M et al. Lipid peroxidation: a novel and unifying concept of the etiology of renal cell carcinoma (United States). Cancer Causes Control 2002; 13: 287–293.
Nissinen A et al. Drug treatment of high blood pressure in the community—experience in eastern Finland. J Hum Hypertens 1989; 3: 165–171.
Wallenius S, Peura S, Klaukka T, Enlund H . Who is using antihypertensive drugs? A prescription analysis from Finland. Scand J Prim Health Care 1996; 14: 54–61.
Calle EE et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 2003; 348: 1625–1638.
Berrington de Gonzalez A, Sweetland S, Spencer E . A meta-analysis of obesity and the risk of pancreatic cancer. Br J Cancer 2003; 89: 519–523.
Friedman GD, van den Eeden SK . Risk factors for pancreatic cancer: an exploratory study. Int J Epidemiol 1993; 22: 30–37.
Stolzenber-Solomon RZ et al. A prospective study of medical conditions, anthropometry, physical activity, and pancreatic cancer in male smokers (Finland). Cancer Causes Control 2002; 13: 417–426.
Weiderpass E et al. Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden). Cancer Causes Control 2000; 11: 185–192.
Brinton LA et al. Ethnicity and variation in breast cancer incidence. Int J Cancer 1997; 73: 349–355.
Inoue M et al. A case–control study on risk factors for uterine endometrial cancer in Japan. Jpn J Cancer Res 1994; 85: 346–350.
Parazzini F et al. The epidemiology of endometrial cancer. Gynecol Oncol 1991; 41: 1–16.
Furberg AS, Thune I . Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer 2003; 104: 669–676.
Moller H, Mellemgaard A, Lindvig K, Olsen JH . Obesity and cancer risk: a Danish record-linkage study. Eur J Cancer 1994; 30A: 344–350.
Caldwell SH, Crespo DM, Kang HS, Al-Osaimi AM . Obesity and hepatocellular carcinoma. Gastroenterology 2004; 127 (5 Suppl 1): S97–S103.
Teppo L, Pukkala E, Lehtonen M . Data quality and quality control of a population-based cancer registry. Experience in Finland. Acta Oncol 1996; 33: 365–369.
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The research was funded with a grant from the Finnish Cultural Foundation and the Finnish Cancer Foundation.
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This work has not been published elsewhere in whole or in part. There are no potential conflicts of interest. The research was funded with a grant from the Finnish Cultural Foundation.
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Lindgren, A., Nissinen, A., Tuomilehto, J. et al. Cancer pattern among hypertensive patients in North Karelia, Finland. J Hum Hypertens 19, 373–379 (2005). https://doi.org/10.1038/sj.jhh.1001834
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DOI: https://doi.org/10.1038/sj.jhh.1001834
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