Hypertension, anti-hypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts

Harding, Jessica L., Sooriyakumaran, Manoshayini, Anstey, Kaarin J., Adams, Robert, Balkau, Beverley, Brennan-Olsen, Sharon, Briffa, Tom, Davis, Timothy M. E., Davis, Wendy A., Dobson, Annette, Giles, Graham G., Grant, Janet, Huxley, Rachel, Knuiman, Matthew, Luszcz, Mary, Mitchell, Paul, Pasco, Julie A., Reid, Christopher M., Simmons, David, Simons, Leon A., Taylor, Anne W., Tonkin, Andrew, Woodward, Mark, Shaw, Jonathan E. and Magliano, Dianna J. (2016) Hypertension, anti-hypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts. Journal of Hypertension, 34 1: 149-155. doi:10.1097/HJH.0000000000000770


Author Harding, Jessica L.
Sooriyakumaran, Manoshayini
Anstey, Kaarin J.
Adams, Robert
Balkau, Beverley
Brennan-Olsen, Sharon
Briffa, Tom
Davis, Timothy M. E.
Davis, Wendy A.
Dobson, Annette
Giles, Graham G.
Grant, Janet
Huxley, Rachel
Knuiman, Matthew
Luszcz, Mary
Mitchell, Paul
Pasco, Julie A.
Reid, Christopher M.
Simmons, David
Simons, Leon A.
Taylor, Anne W.
Tonkin, Andrew
Woodward, Mark
Shaw, Jonathan E.
Magliano, Dianna J.
Title Hypertension, anti-hypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts
Journal name Journal of Hypertension   Check publisher's open access policy
ISSN 0263-6352
1473-5598
Publication date 2016-01-01
Sub-type Article (original research)
DOI 10.1097/HJH.0000000000000770
Open Access Status Not Open Access
Volume 34
Issue 1
Start page 149
End page 155
Total pages 7
Place of publication London, United Kingdom
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2724 Internal Medicine
1314 Physiology
2705 Cardiology and Cardiovascular Medicine
Abstract 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.
Formatted abstract
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.
Keyword Antihypertensive treatment
Cancer
Cancer mortality
Hypertension
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1002663
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Public Health Publications
 
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Created: Thu, 19 Nov 2015, 00:03:24 EST by Alison Manley on behalf of School of Public Health