Hypertension and Risk of Renal Cell Carcinoma Among White and Black Americans

Abstract

BACKGROUND Renal cell carcinoma and hypertension (a well-established renal cancer risk factor) are both more frequent among blacks than whites in the U.S. The association between hypertension and renal cell carcinoma has not been examined in black Americans. We investigated the hypertension–renal cancer association by race, and we assessed the role of hypertension in the racial disparity of renal cancer incidence. METHODS Participants were enrolled in a population-based case-control study in Detroit and Chicago during 2002–2007 (number of cases: 843 whites, 358 blacks; number of controls: 707 whites, 519 blacks). Participants reported their history of hypertension and antihypertensive drug use. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for demographic characteristics, smoking, body mass index, and family history of cancer. RESULTS Hypertension doubled renal cancer risk (OR=2.0 [CI=1.7–2.5]) overall. For whites the OR was 1.9 (CI=1.5–2.4), while for blacks it was 2.8 (2.1–3.8) (p for interaction=0.11). ORs increased with time after hypertension diagnosis (p for trend <0.001), reaching 4.1 (CI=2.3–7.4) for blacks and 2.6 (CI=1.7–4.1) for whites after 25 years. ORs for poorly controlled hypertension were 4.5 (CI=2.3–8.8) for blacks and 2.1 (CI=1.2–3.8) for whites. If these estimates correctly represent causal effects and if, hypothetically, hypertension could be prevented entirely among persons aged 50–79 years, the black/white disparity in renal cancer could be reversed among women and reduced by two-thirds among men. CONCLUSIONS Hypertension is a risk factor for renal cancer among both blacks and whites, and might explain a substantial portion of the racial disparity in renal cancer incidence. Preventing and controlling hypertension might reduce renal cancer incidence, adding to the known benefits of blood pressure control for heart disease and stroke reduction, particularly among blacks.

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

“…Może to być również czynnik przyczynowy, jak np. w raku nerki [160]. Stosowanie inhibitorów VEGF wiąże się z dużym ryzykiem (11-45%) wywołania nowego nadciśnienia lub destabilizacji uprzednio dobrze kontrolowanego nadciśnienia, w tym wystąpienia ciężkiego nadciśnienia w 2-20% przypadków [161,162].…”

Renal cell carcinoma risk associated with lower intake of micronutrients

“…The study was conducted in the metropolitan areas of Detroit (Wayne, Oakland, and Macomb counties), Michigan and Chicago (Cook County), Illinois 4. The study was approved by the Institutional Review Boards (IRB) of all participating institutions.…”

“…Controls were identified using motor vehicle records (20‐65 years old) and Medicare eligibility files (65‐79 years old). A detailed description of the sampling strategy is provided Colt et al 4. Controls were frequency matched to cases 2:1 in AA and 1:1 in EA on study center, race, sex, and five‐year age categories.…”

“…Renal cell carcinoma (RCC) makes up approximately 90% of kidney cancer cases, and risk factors include cigarette smoking, obesity, hypertension, and alcohol 2, 4, 5, 6, 7, 8, 9, 10, 11. Racial differences in the distribution of several of these risk factors likely account for some of the excess risk observed in AA as compared to EA populations 4, 12, 13.…”

“…Racial differences in the distribution of several of these risk factors likely account for some of the excess risk observed in AA as compared to EA populations 4, 12, 13. Many vitamins from diet and supplements, including vitamin A, C, and B, have been shown to have antioxidative effects and may influence RCC risk 5, 6, 7, 8, 14, 15.…”