TY - JOUR
T1 - Hypertension, antihypertensive treatment and cancer incidence and mortality
T2 - A pooled collaborative analysis of 12 Australian and New Zealand cohorts
AU - Harding, Jessica L.
AU - Sooriyakumaran, Manoshayini
AU - Anstey, Kaarin J.
AU - Adams, Robert
AU - Balkau, Beverley
AU - Brennan-Olsen, Sharon
AU - Briffa, Tom
AU - Davis, Timothy M.E.
AU - Davis, Wendy A.
AU - Dobson, Annette
AU - Giles, Graham G.
AU - Grant, Janet
AU - Huxley, Rachel
AU - Knuiman, Matthew
AU - Luszcz, Mary
AU - Mitchell, Paul
AU - Pasco, Julie A.
AU - Reid, Christopher M.
AU - Simmons, David
AU - Simons, Leon A.
AU - Taylor, Anne W.
AU - Tonkin, Andrew
AU - Woodward, Mark
AU - Shaw, Jonathan E.
AU - Magliano, Dianna J.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: Observational studies examining associations between hypertension and cancer are inconsistent. We explored the association of hypertension, graded hypertension and antihypertensive treatment with cancer incidence and mortality. Method: Eighty-six thousand five hundred and ninety-three participants from the Australian and New Zealand Diabetes and Cancer Collaboration were linked to the National Death Index and Australian Cancer Database. Cox proportional hazards models estimated hazard ratios and 95% confidence intervals (95% CI) for the association of treated and untreated hypertension with cancer incidence and mortality. Results: Over a median follow-up of 15.1 years, 12 070 incident and 4350 fatal cancers were identified. Untreated and treated hypertension, compared with normotension, were associated with an increased risk for cancer incidence [hazard ratio 1.06, 95% CI (1.00-1.11) and 1.09 (1.02-1.16) respectively], and cancer mortality (1.07, 0.98-1.18) and (1.15, 1.03-1.28), respectively. When compared with untreated hypertension, treated hypertension did not have a significantly greater risk for cancer incidence (1.03, 0.97-1.10) or mortality (1.07, 0.97-1.19). A significant dose-response relationship was observed between graded hypertension and cancer incidence and mortality; P trend = 0.053 and P trend = 0.001, respectively. When stratified by treatment status, these relationships remained significant in untreated, but not in treated, hypertension. Conclusion: Hypertension, both treated and untreated, is associated with a modest increased risk for cancer incidence and mortality. Similar risks in treated and untreated hypertension suggest that the increased cancer risk is not explained by the use of antihypertensive treatment.
AB - Background: Observational studies examining associations between hypertension and cancer are inconsistent. We explored the association of hypertension, graded hypertension and antihypertensive treatment with cancer incidence and mortality. Method: Eighty-six thousand five hundred and ninety-three participants from the Australian and New Zealand Diabetes and Cancer Collaboration were linked to the National Death Index and Australian Cancer Database. Cox proportional hazards models estimated hazard ratios and 95% confidence intervals (95% CI) for the association of treated and untreated hypertension with cancer incidence and mortality. Results: Over a median follow-up of 15.1 years, 12 070 incident and 4350 fatal cancers were identified. Untreated and treated hypertension, compared with normotension, were associated with an increased risk for cancer incidence [hazard ratio 1.06, 95% CI (1.00-1.11) and 1.09 (1.02-1.16) respectively], and cancer mortality (1.07, 0.98-1.18) and (1.15, 1.03-1.28), respectively. When compared with untreated hypertension, treated hypertension did not have a significantly greater risk for cancer incidence (1.03, 0.97-1.10) or mortality (1.07, 0.97-1.19). A significant dose-response relationship was observed between graded hypertension and cancer incidence and mortality; P trend = 0.053 and P trend = 0.001, respectively. When stratified by treatment status, these relationships remained significant in untreated, but not in treated, hypertension. Conclusion: Hypertension, both treated and untreated, is associated with a modest increased risk for cancer incidence and mortality. Similar risks in treated and untreated hypertension suggest that the increased cancer risk is not explained by the use of antihypertensive treatment.
KW - antihypertensive treatment
KW - cancer
KW - cancer mortality
KW - hypertension
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U2 - 10.1097/HJH.0000000000000770
DO - 10.1097/HJH.0000000000000770
M3 - Article
C2 - 26630217
AN - SCOPUS:84950141477
SN - 0263-6352
VL - 34
SP - 149
EP - 155
JO - Journal of hypertension
JF - Journal of hypertension
IS - 1
ER -