A cohort study of antihypertensive treatments and risk of renal cell cancer

Abstract

We studied 335 682 county residents, of whom 113 298 had been prescribed antihypertensive treatment (AHT), in the period 1989 -2002 in North Jutland County, Denmark to examine the relation between different AHTs and the risk of renal cell carcinoma (RCC). An internal comparison was performed among the different classes of AHT users with users of beta blockers as the reference, in order to address potential confounding and bias. The average follow-up was 10 years (range 0 -13). Use of any AHT was associated with RCC (relative rate (RR) ¼ 1.6, 95% confidence interval (CI) 1.3 -1.9) compared with nonusers in the general population. Specific classes of AHTs were nonsignificantly associated with RCC, but compared with users of beta blockers, the numbers observed were close to expectation. Analyses by duration of follow-up and number of prescriptions revealed no clear trends for any antihypertensive agent and after 5-years of follow-up, the RRs for all classes of AHT decreased. The elevated RRs for RCC among users of AHTs compared with the general population are unlikely to be causal, but rather reflect confounding due to failure to control for pre-existing hypertension, and protopathic bias, due to the presence of hypertension as an early sign of kidney disease.

The association between antihypertensive drugs and glioma

“…There is evidence that renal carcinoma is associated with diuretic use (Grossman et al, 2001), although this is not generally accepted (Choi et al, 2005;Fryzek et al, 2005). Prenatal exposure to diuretics was associated with an increased risk of childhood brain tumours (Preston-Martin et al, 1982), which could not be confirmed by subsequent studies (Kuijten et al, 1990;McCredie et al, 1994;McKean-Cowdin et al, 2003).…”

Blood pressure and renal cancer risk: the HUNT Study in Norway

“…In two prospective studies, antihypertensive treatment was associated with higher risk of renal cell cancer (Fraser et al, 1990;Heath et al, 1997), but others found no association (Grove et al, 1991;Flaherty et al, 2005;Schouten et al, 2005). One large study linking prescriptions and cancer registration in Denmark indicated that antihypertensive medication may increase risk, but was interpreted as being due to confounding by underlying hypertension (Fryzek et al, 2005). One prospective study (Flaherty et al, 2005) and two case -control studies (Yuan et al, 1998;Shapiro et al, 1999) have also reported positive associations with a history of hypertension.…”

“…In men, there was no association with blood pressure. The association of blood pressure with risk of renal cell cancer has been investigated in a number of cohort (Fraser et al, 1990;Grove et al, 1991;Coughlin et al, 1997;Heath et al, 1997;Chow et al, 2000;Choi et al, 2005;Flaherty et al, 2005;Fryzek et al, 2005;Lindgren et al, 2005;Schouten et al, 2005) and case -control (McLaughlin et al, 1995;Yuan et al, 1998;Shapiro et al, 1999) studies, using as principal exposure variable either recorded blood pressure or reported hypertension. In men, recorded blood pressure has shown a convincing exposure -response gradient related to renal cell cancer risk (Coughlin et al, 1997;Chow et al, 2000).…”

Böbrek Hücreli Karsinomda Risk Faktörleri ve Etyoloji

“…Anti hipertansif ilaçların, özellikle de diüretiklerin proksimal tübül üzerine etkili olmaları ve BHK'nında daha çok buradan gelişmesi nedeniyle bu ajanların kullanımının BHK'nın potansiyel sebeplerinden olabileceği (25) ileri sürülmesine rağmen kanıtlanmamıştır (26). Literatürde bu konuda görüş birliği yoktur.…”