Detecting hypertension: screening versus case finding in Norway.

Holmen, Jostein; Forsén, Lisa; Hjort, Peter Fredrik; Midthjell, Kristian; Waaler, Hans Th.; A, Bjørndal

doi:10.1136/bmj.302.6770.219

Cited by 29 publications

(20 citation statements)

References 13 publications

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“…In 1984, 85 100 individuals were invited to the Nord Trøndelag Health Study (the HUNT Study) in Norway, and 75 058 (88.2 percent) accepted the invitation, filled in a self-administered questionnaire, and attended a clinical examination (Holmen et al, 1991;Ellekjaer et al, 2000). Briefly, information included smoking status and standardised measurements of blood pressure, body height and weight.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2007

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In a prospective study of 36 728 women and 35 688 men during 18 years of follow-up, compared to systolic pressure o130 mm Hg, levels of 130 -149, 150 -169 and X170 mm Hg in women were associated with relative risks of renal cell cancer of 1.7, 2.0 and 2.0, respectively (P for linear trend, 0.11). 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). In women, however, only reported history of hypertension has been studied as the main exposure variable. In one cohort (Flaherty et al, 2005) and two case -control studies (Yuan et al, 1998;Shapiro et al, 1999), history of hypertension was associated with increased risk. Documenting the presence or the lack of an exposure -response gradient in women is important, and might promote a better probing of the underlying mechanism of the association.In this prospective study of 36 728 women and 35 688 men, we report on the association of blood pressure measured at baseline with renal cell cancer risk during 18 years of follow-up, together with that related to ever use of blood pressure medication. MATERIALS AND METHODSIn 1984, 85 100 individuals were invited to the Nord Trøndelag Health Study (the HUNT Study) in Norway, and 75 058 (88.2 percent) accepted the invitation, filled in a self-administered questionnaire, and attended a clinical examination (Holmen et al, 1991;Ellekjaer et al, 2000). Briefly, information included smoking status and standardised measurements of blood pressure, body height and weight. The study was approved by the Regional Committee for Ethics in medical research, and by the Norwegian Data Inspectorate.This study was restricted to participants without prevalent cancer who had complete information on blood pressure and body mass index. Blood pressure was measured using calibrated mercury manometers with standard cuff size (Holmen et al, 1991). We divided systolic pressure (in mm Hg) into the following categories: o130 (reference), 130 -149, 150 -169 and X170, and diastolic pressure (in mm Hg) into the following: o85 (reference), 85 -94, 95 -104 and X105. Information on use of antihypertensive medication was derived from the question 'do you use or have you ever used blood pressure medication?' Body mass index was calculated as weight (in kg) divided by the squared value of height (in metres), and grouped into four categories: o18.5, 18.5 -24.9, 25 -29.9 and X30. Information on smoking was categorised as never, former o...

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Section: Methodsmentioning

confidence: 99%

“…Blood pressure was measured using calibrated mercury manometers with standard cuff size (Holmen et al, 1991). We divided systolic pressure (in mm Hg) into the following categories: o130 (reference), 130 -149, 150 -169 and X170, and diastolic pressure (in mm Hg) into the following: o85 (reference), 85 -94, 95 -104 and X105.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2007

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“…The study has been described in detail elsewhere. 10 Among the 36,522 men who participated, 790 men with prevalent cancer (of any site) were excluded from analysis. Among the remaining 35,732 men, 6,622 failed to return the second questionnaire, leaving 29,110 men eligible for prostate cancer follow-up.…”

Section: Study Populationmentioning

confidence: 99%

Recreational physical activity and risk of prostate cancer: A prospective population‐based study in Norway (the HUNT study)

Nilsen

Romundstad

Vatten

2006

Intl Journal of Cancer

101

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Physical activity has been studied in relation to prostate cancer risk, but the findings have been inconclusive. We prospectively examined the association between self-reported recreational physical activity and overall risk of prostate cancer, risk of advanced disease and risk of prostate cancer death in a cohort of 29,110 Norwegian men. Incident prostate cancers were obtained from the Norwegian Cancer Registry, and prostate cancer deaths were obtained from the national Cause of Death Registry. During 17 years of follow-up, 957 incident cases were identified, 266 of them were advanced (i.e. metastases at diagnosis) and 354 of the incident cases died from prostate cancer. In multivariable analysis, frequency and duration of exercise were inversely associated with the risk of advanced prostate cancer (p for trend 5 0.04 and 0.02). We computed a summary score that combined frequency, duration and intensity of exercise, and this score showed inverse associations with advanced prostate cancer risk and mortality (p for trend 5 0.02 and 0.07). Compared to men who reported no activity, the relative risks (95% confidence intervals) among men in the highest category of physical exercise was 0.64 (0.43-0.95) for advanced prostate cancer and 0.67 (0.48-0.94) for prostate cancer death. We found no association between physical activity and overall risk of prostate cancer. We conclude that recreational physical exercise is associated with reduced risk of advanced prostate cancer and prostate cancer death. ' 2006 Wiley-Liss, Inc.

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“…A detailed description of the HUNT Study is given elsewhere (Holmen et al, 1991). Among the 38 260 women who participated, we excluded 1088 with prevalent cancer (except basal cell carcinoma) and 417 because their body mass index (BMI) could not be calculated.…”

Section: Methodsmentioning

confidence: 99%

“…1984 and 1986, all inhabitants aged 20 years and older in the Nord-Trøndelag County in Norway were invited to participate in a study (the HUNT-I Study), in which standardised measurements of height and weight were made. A detailed description of the HUNT Study is given elsewhere (Holmen et al, 1991). Among the 38 260 women who participated, we excluded 1088 with prevalent cancer (except basal cell carcinoma) and 417 because their body mass index (BMI) could not be calculated.…”

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The impact of BMI on subgroups of uterine cancer

et al. 2009

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BACKGROUND: Obesity increases the risk of uterine cancer, but results by histological type have differed. METHODS: We followed 36 755 women for 17.8 years for uterine cancers. RESULTS AND CONCLUSION: Body mass index (BMI) was positively associated with uterine cancers as a whole, particularly for endometrioid adenocarcinomas, for which the relative risk for very obese women (BMI: X40 kg m À2 ) compared with lean (BMI: 20 -24 kg m À2 ) women, was 11.1 (95% confidence interval: 5.2 -23.8). The obesity epidemic contributes to a steadily increasing incidence of endometrial cancer for which obese women may have a six-fold higher risk compared with lean women (Lindemann et al, 2008). Most studies have assessed the effect on uterine cancers as a whole (Tretli and Magnus, 1990;Jonsson et al, 2003;Bjorge et al, 2007) or endometrial cancer without further differentiation Levi et al, 1992;Shu et al, 1992;Swanson et al, 1993;de Waard et al, 1996;Goodman et al, 1997;Schouten et al, 2006;Trentham-Dietz et al, 2006). However, it has been hypothesised that the positive association of obesity may be restricted to endometrioid adenocarcinomas, as this subtype appears to be oestrogen dependent, and oestrogen is produced in the adipose tissue (Siiteri, 1987;Azziz, 1989).Two population-based studies have addressed the issue of whether obesity is differentially associated with histological subtypes of uterine cancer, but with inconsistent results. In one study, there was a stronger positive association with endometrioid adenocarcinoma (type I tumours) than for other subtypes (type II tumours, such as papillary, serous and clear cell adenocarcinomas, and some poorly differentiated carcinomas), as well as a weaker association for sarcomas and mixed endothelial and mesenchymal tumours (Bjorge et al, 2007). The other study differentiated between carcinoma and sarcoma variants, and found increased risk associated with obesity only for carcinomas (Tretli and Magnus, 1990).In this prospective study of 36 755 women, we have compared the association of BMI with the risk of uterine cancer as a single entity, with all endometrial cancers, and with the risk of endometrioid adenocarcinomas. MATERIALS AND METHODSBetween 1984 and 1986, all inhabitants aged 20 years and older in the Nord-Trøndelag County in Norway were invited to participate in a study (the HUNT-I Study), in which standardised measurements of height and weight were made. A detailed description of the HUNT Study is given elsewhere (Holmen et al, 1991). Among the 38 260 women who participated, we excluded 1088 with prevalent cancer (except basal cell carcinoma) and 417 because their body mass index (BMI) could not be calculated. Thus, 36 755 women were followed up for cancer incidence.Women diagnosed with cancer of the uterine corpus (International Classification of Diseases, 7th revision, ICD-7, code 172) were identified by the linkage of HUNT Study participants to the Norwegian Cancer Registry, using the unique 11-digit identity number of Norwegian citizens. Follow-up time was calc...

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Detecting hypertension: screening versus case finding in Norway.

Cited by 29 publications

References 13 publications

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

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

Recreational physical activity and risk of prostate cancer: A prospective population‐based study in Norway (the HUNT study)

The impact of BMI on subgroups of uterine cancer

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