Obesity, Hypertension, and the Risk of Kidney Cancer in Men

Chow, Wong Ho; Gridley, Gloria; Fraumeni, Joseph F.; Järvholm, Bengt

doi:10.1056/nejm200011023431804

Cited by 582 publications

(448 citation statements)

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“…Information on well known or suspected risk factors for RCC, such as cigarette smoking, obesity and possibly hypertension was not available. Several large-scale population-based case -control and cohort studies which adjusted for use of diuretics and other AHT have reported elevated relative risks for RCC associated with hypertension, independent of use of AHT (McLaughlin et al, 1995;Yuan et al, 1998;Chow et al, 2000;McLaughlin and Lipworth, 2000). In contrast, adjustment for high blood pressure appears to eliminate any excess risk for RCC associated with AHT use (McLaughlin et al, 1995;Yuan et al, 1998;Shapiro et al, 1999;McLaughlin and Lipworth, 2000).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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“…6 Several studies have examined associations between hypertension and cancer risk. Although there appears to be consistent evidence linking hypertension with both renal cancer 7,8 and endometrial cancer particularly among obese women, 9-11 the results for breast cancer have been less consistent. At least two studies have reported a positive association of hypertension with breast cancer risk, 9,12 whereas others have not reported an association with breast cancer risk 4,13,14 or mortality.…”

Section: Introductionmentioning

confidence: 99%

Hypertension, diuretics and breast cancer risk

et al. 2006

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It is unclear whether hypertension and antihypertensive medication use are associated with breast cancer. In order to examine these associations, we conducted a case-control study among women aged 50-75 years. Breast cancer cases were ascertained via a populationbased cancer registry (n ¼ 523) and controls were ascertained via random-digit-dialing (n ¼ 131). Participants completed a self-administered questionnaire which queried history of hypertension, antihypertensive medication use and risk factors. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for age, body mass index (BMI), diabetes, smoking, alcohol use, menopausal status, family history of breast or ovarian cancer, age at first full-term pregnancy and education.History of treated hypertension was associated with significant increased risk of breast cancer (OR, 1.77; 95% CI, 1.04-3.03) and this association appeared only in women with BMI X25 kg/m 2 (OR, 2.30; 95% CI, 1.12-4.71). Diuretic use was also associated with elevated breast cancer risk (OR, 1.79; 95% CI, 1.07-3.01). The risk associated with diuretic use increased with duration of use (P for trend, o0.01). Use of other blood pressure medications was not found to be associated with breast cancer risk. These results support a positive association between treated hypertension, diuretic use and breast cancer risk among women aged 50-75 years.

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“…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.…”

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confidence: 99%

“…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.…”

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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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Obesity, Hypertension, and the Risk of Kidney Cancer in Men

Abstract: Higher body-mass index and elevated blood pressure independently increase the long-term risk of renal-cell cancer in men. A reduction in blood pressure lowers the risk.

Cited by 582 publications

References 20 publications

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

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

Hypertension, diuretics and breast cancer risk

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

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