Incidence of and mortality from cancer in hypertensive patients.

Hole, David; Hawthorne, Victor M.; Isles, Christopher; McGhee, SM; Robertson, James Louis; Gillis, Charles R.; Wapshaw, Jean A.; Lever, A. F.

doi:10.1136/bmj.306.6878.609

Cited by 71 publications

(32 citation statements)

References 9 publications

(2 reference statements)

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“…This finding stands in contrast to an Australian case-control study reporting a significant 2-fold excess of renal pelvis cancer among women using nondiuretic antihypertensive drugs, especially beta-blockers (McCredie and Stewart, 1992). In addition, an excess of renal cancer has been suggested in 2 prospective surveys (Fletcher et al, 1993;Hole et al, 1993) of hypertensive patients taking beta-blockers, but the subsites were not specified and the relation was attributed to hypertension rather than medication use. Reasons for the differences are not clear, but the negative findings in our study may be Since the use of diuretics, beta-blockers and other antihypertensive drugs is highly correlated with hypertension, it is difficult to differentiate the effects of hypertension and its treatment on cancer risk.…”

Section: Discussioncontrasting

confidence: 74%

Possible relation between hypertension and cancers of the renal pelvis and ureter

et al. 1997

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To evaluate the relationship of selected medical conditions and medications with cancers of the renal pelvis and ureter, we interviewed 308 subjects with renal pelvis cancer, 194 subjects with ureter cancer and 496 control subjects in 3 areas of the United States. After controlling for the effects of smoking, age, gender and geographic residence, a history of hypertension (reported to have been diagnosed more than 5 years before interview) was associated with a small but significantly increased risk (odds ratio [OR] 5 1.3; 95% confidence interval [CI], 1.0-1.8), whereas no relationship was observed with a variety of other medical conditions or medications. Stratified analysis showed that the risk associated with hypertension was twice as high among users of diuretics or other antihypertensive drugs (OR 5 2.4; 95% CI, 1.1-4.9) as it was among those who never used these medications (OR 5 1.2; 95% CI, 0.8-1.7). Our findings suggest that the association previously reported between hypertension and renal cell cancer may extend to cancers of the renal pelvis and ureter. Int. J. Cancer, 70: 265-268, 1997.r 1997 Wiley-Liss, Inc.* Cancers of the renal pelvis and ureter, both lined by transitional epithelium, are uncommon tumors that account for less than 1% of all newly diagnosed cancers in the United States (Devesa et al., 1990). However, the incidence rates have been rising by 2 to 4% annually among both men and women (Devesa et al., 1990). Although there have been relatively few epidemiologic studies, the major risk factor is cigarette smoking, which is believed to account for most of these tumors .Previous studies have linked heavy use of analgesics, especially preparations containing phenacetin, to an elevated risk of renal pelvis and ureter cancers (McCredie et al., 1982(McCredie et al., , 1993McLaughlin et al., 1983;Jensen et al., 1989). However, data from the present study revealed no association (Linet et al., 1995), probably because phenacetin was discontinued many years ago in the United States and the carcinogenic effects may no longer be apparent. To investigate further the role of prior medical conditions and pharmaceutical agents in the development of these cancers, we examined data from a large-scale, population-based, case-control study conducted in 3 geographic areas in the United States. METHODSDetailed methods for this study have already been described Linet et al., 1995). Briefly, cases were individuals aged 20-79, newly diagnosed with microscopically confirmed cancers of the renal pelvis or ureter between January 1, 1983, and December 31, 1986, and living in New Jersey, Iowa or Los Angeles County, California. Non-white cases in these areas were excluded from the study because of very small numbers. Population-based control subjects were frequency-matched to the index cases based on age (5-year group), sex, and geographic area and were chosen by random digit dialing (RDD) (Waksberg, 1978) for cases younger than 65 or selected from Medicare files of the Health Care Financing Administration (HCFA) for ...

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Section: Discussioncontrasting

confidence: 74%

Possible relation between hypertension and cancers of the renal pelvis and ureter

et al. 1997

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“…Thereafter, some investigators reported that the use of diuretic and beta-blockers in hypertensives increased morbidity from renal cancer. [29][30][31] In this study, we have demonstrated that blood pressure is an independent risk factor for cancer after adjusting for age, sex, and alcohol consumption. SBP was not significant in the multiple logistic regression analysis, which may possibly be ascribed to the coexisting high SBP and DBP in most hypertensive patients.…”

Section: Discussionmentioning

confidence: 53%

“…As some kidney cancers cause hypertension, an increased frequency of kidney cancer is to be expected in a hypertension clinic and some investigators reported that kidney cancer was the only type to be significantly increased. 31 However, excess lung, colon genitourinary, endometrium, ovary and digestive cancer have been reported in another study. 29 In our study, the excess cancer found arose mainly in the digestive system; this accounted for around three-quarters of the total.…”

Section: Discussionmentioning

confidence: 88%

Hypertension is associated with a high risk of cancer

Xie

Ke-gui

et al. 1999

J Hum Hypertens

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To investigate the possible relationship between hypertension and cancer, a retrospective analysis was carried out using a database including 1225 cases, of which 552 were hypertensives and 673 normotensives. Seventy cases of cancers with different origins were found during a 17-year follow-up. Odds ratio (OR) for occurrence of cancer was calculated. It was shown that an age over 40 years, male sex, alcohol-taking, systolic and diastolic blood pressures (SBP/DBP) were the five risk factors for the occurrence of cancers, while occupation, smoking, body mass index, left ventricular hypertrophy, and antihypertensive medication had no effect on cancer incidence. Hypertensives were at a high risk of overall cancer incidence with OR 2.2 (P Ͻ 0.01). After stratification of age, OR for hypertensives aged 40-49 years old with SBP у140 mm Hg or DBP у90mm Hg was 3.18 and 2.98

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“…Previous studies were based on much smaller study populations (Grove et al, 1991;Hole et al, 1993;Rosengren et al, 1998) the largest study to date was based on 69 cases and reported no association (Grove et al, 1991). A study with 1585 cases, investigated the relationships between hypertension, hypertension medication and bladder cancer risk in a population-based case control study conducted in Los Angeles, and found a reduced risk of bladder cancer among hypertensive subjects who did not use antihypertensives or diuretics regularly and this reduction in risk was limited to smokers and carriers of the GSTM1-null genotype.…”

Section: Discussionmentioning

confidence: 99%