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Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition

Christakoudi, Sofia; Kakourou, Artemisia; Markozannes, Georgios; Tzoulaki, Ioanna; Weiderpass, Elisabete; Brennan, Paul; Gunter, Marc; Dahm, Christina C.; Overvad, Kim and Olsen, Anja, et al. (2019) In International Journal of Cancer
Abstract

Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4)... (More)

Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08–1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14–1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07–1.26) (SBP), HR = 1.31 (1.13–1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04–1.12) (SBP), HR = 1.09 (1.01–1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82–1.00) and lymphomas: HR = 0.97 (0.93–1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.

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association, cancer, cohort, epidemiology, Europe, hypertension, morphology, risk factors
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International Journal of Cancer
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John Wiley & Sons
external identifiers
  • scopus:85071268694
ISSN
0020-7136
DOI
10.1002/ijc.32576
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English
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yes
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558e1ece-d995-4172-acf2-e473f0527da8
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2019-09-12 13:23:05
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2019-10-01 03:47:05
@article{558e1ece-d995-4172-acf2-e473f0527da8,
  abstract     = {<p>Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08–1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14–1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07–1.26) (SBP), HR = 1.31 (1.13–1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04–1.12) (SBP), HR = 1.09 (1.01–1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82–1.00) and lymphomas: HR = 0.97 (0.93–1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.</p>},
  author       = {Christakoudi, Sofia and Kakourou, Artemisia and Markozannes, Georgios and Tzoulaki, Ioanna and Weiderpass, Elisabete and Brennan, Paul and Gunter, Marc and Dahm, Christina C. and Overvad, Kim and Olsen, Anja and Tjønneland, Anne and Boutron-Ruault, Marie Christine and Madika, Anne Laure and Severi, Gianluca and Katzke, Verena and Kühn, Tilman and Bergmann, Manuela M. and Boeing, Heiner and Karakatsani, Anna and Martimianaki, Georgia and Thriskos, Paschalis and Masala, Giovanna and Sieri, Sabina and Panico, Salvatore and Tumino, Rosario and Ricceri, Fulvio and Agudo, Antonio and Redondo-Sánchez, Daniel and Colorado-Yohar, Sandra M. and Mokoroa, Olatz and Melander, Olle and Stocks, Tanja and Häggström, Christel and Harlid, Sophia and Bueno-de-Mesquita, Bas and van Gils, Carla H. and Vermeulen, Roel C.H. and Khaw, Kay Tee and Wareham, Nicholas J. and Tong, Tammy Y.N. and Freisling, Heinz and Johansson, Mattias and Lennon, Hannah and Aune, Dagfinn and Riboli, Elio and Trichopoulos, Dimitrios and Trichopoulou, Antonia and Tsilidis, Konstantinos K.},
  issn         = {0020-7136},
  keyword      = {association,cancer,cohort,epidemiology,Europe,hypertension,morphology,risk factors},
  language     = {eng},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1002/ijc.32576},
  year         = {2019},
}