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The relationship between blood pressure and risk of renal cell carcinoma

Alcala, Karine ; Mariosa, Daniela ; Smith-Byrne, Karl ; Nasrollahzadeh Nesheli, Dariush ; Carreras-Torres, Robert ; Ardanaz Aicua, Eva ; Bondonno, Nicola P ; Bonet, Catalina ; Brunström, Mattias and Bueno-de-Mesquita, Bas , et al. (2022) In International Journal of Epidemiology 51(4). p.1317-1327
Abstract

BACKGROUND: The relation between blood pressure and kidney cancer risk is well established but complex and different study designs have reported discrepant findings on the relative importance of diastolic blood pressure (DBP) and systolic blood pressure (SBP). In this study, we sought to describe the temporal relation between diastolic and SBP with renal cell carcinoma (RCC) risk in detail.

METHODS: Our study involved two prospective cohorts: the European Prospective Investigation into Cancer and Nutrition study and UK Biobank, including >700 000 participants and 1692 incident RCC cases. Risk analyses were conducted using flexible parametric survival models for DBP and SBP both separately as well as with mutuality adjustment... (More)

BACKGROUND: The relation between blood pressure and kidney cancer risk is well established but complex and different study designs have reported discrepant findings on the relative importance of diastolic blood pressure (DBP) and systolic blood pressure (SBP). In this study, we sought to describe the temporal relation between diastolic and SBP with renal cell carcinoma (RCC) risk in detail.

METHODS: Our study involved two prospective cohorts: the European Prospective Investigation into Cancer and Nutrition study and UK Biobank, including >700 000 participants and 1692 incident RCC cases. Risk analyses were conducted using flexible parametric survival models for DBP and SBP both separately as well as with mutuality adjustment and then adjustment for extended risk factors. We also carried out univariable and multivariable Mendelian randomization (MR) analyses (DBP: ninstruments = 251, SBP: ninstruments = 213) to complement the analyses of measured DBP and SBP.

RESULTS: In the univariable analysis, we observed clear positive associations with RCC risk for both diastolic and SBP when measured ≥5 years before diagnosis and suggestive evidence for a stronger risk association in the year leading up to diagnosis. In mutually adjusted analysis, the long-term risk association of DBP remained, with a hazard ratio (HR) per standard deviation increment 10 years before diagnosis (HR10y) of 1.20 (95% CI: 1.10-1.30), whereas the association of SBP was attenuated (HR10y: 1.00, 95% CI: 0.91-1.10). In the complementary multivariable MR analysis, we observed an odds ratio for a 1-SD increment (ORsd) of 1.34 (95% CI: 1.08-1.67) for genetically predicted DBP and 0.70 (95% CI: 0.56-0.88) for genetically predicted SBP.

CONCLUSION: The results of this observational and MR study are consistent with an important role of DBP in RCC aetiology. The relation between SBP and RCC risk was less clear but does not appear to be independent of DBP.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood Pressure, Carcinoma, Renal Cell/epidemiology, Humans, Hypertension/epidemiology, Kidney Neoplasms/epidemiology, Prospective Studies, Risk Factors
in
International Journal of Epidemiology
volume
51
issue
4
pages
1317 - 1327
publisher
Oxford University Press
external identifiers
  • pmid:35312764
  • scopus:85136210831
ISSN
1464-3685
DOI
10.1093/ije/dyac042
language
English
LU publication?
yes
additional info
© World Health Organization, 2022. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.
id
80fbe351-68e9-4763-9db1-1ce8d639695a
date added to LUP
2023-01-13 09:17:12
date last changed
2024-05-16 21:30:59
@article{80fbe351-68e9-4763-9db1-1ce8d639695a,
  abstract     = {{<p>BACKGROUND: The relation between blood pressure and kidney cancer risk is well established but complex and different study designs have reported discrepant findings on the relative importance of diastolic blood pressure (DBP) and systolic blood pressure (SBP). In this study, we sought to describe the temporal relation between diastolic and SBP with renal cell carcinoma (RCC) risk in detail.</p><p>METHODS: Our study involved two prospective cohorts: the European Prospective Investigation into Cancer and Nutrition study and UK Biobank, including &gt;700 000 participants and 1692 incident RCC cases. Risk analyses were conducted using flexible parametric survival models for DBP and SBP both separately as well as with mutuality adjustment and then adjustment for extended risk factors. We also carried out univariable and multivariable Mendelian randomization (MR) analyses (DBP: ninstruments = 251, SBP: ninstruments = 213) to complement the analyses of measured DBP and SBP.</p><p>RESULTS: In the univariable analysis, we observed clear positive associations with RCC risk for both diastolic and SBP when measured ≥5 years before diagnosis and suggestive evidence for a stronger risk association in the year leading up to diagnosis. In mutually adjusted analysis, the long-term risk association of DBP remained, with a hazard ratio (HR) per standard deviation increment 10 years before diagnosis (HR10y) of 1.20 (95% CI: 1.10-1.30), whereas the association of SBP was attenuated (HR10y: 1.00, 95% CI: 0.91-1.10). In the complementary multivariable MR analysis, we observed an odds ratio for a 1-SD increment (ORsd) of 1.34 (95% CI: 1.08-1.67) for genetically predicted DBP and 0.70 (95% CI: 0.56-0.88) for genetically predicted SBP.</p><p>CONCLUSION: The results of this observational and MR study are consistent with an important role of DBP in RCC aetiology. The relation between SBP and RCC risk was less clear but does not appear to be independent of DBP.</p>}},
  author       = {{Alcala, Karine and Mariosa, Daniela and Smith-Byrne, Karl and Nasrollahzadeh Nesheli, Dariush and Carreras-Torres, Robert and Ardanaz Aicua, Eva and Bondonno, Nicola P and Bonet, Catalina and Brunström, Mattias and Bueno-de-Mesquita, Bas and Chirlaque, María-Dolores and Christakoudi, Sofia and Heath, Alicia K and Kaaks, Rudolf and Katzke, Verena and Krogh, Vittorio and Ljungberg, Börje and Martin, Richard M and May, Anne and Melander, Olle and Palli, Domenico and Rodriguez-Barranco, Miguel and Sacerdote, Carlotta and Stocks, Tanja and Tjønneland, Anne and Travis, Ruth C and Vermeulen, Roel and Chanock, Stephen and Purdue, Mark and Weiderpass, Elisabete and Muller, David and Brennan, Paul and Johansson, Mattias}},
  issn         = {{1464-3685}},
  keywords     = {{Blood Pressure; Carcinoma, Renal Cell/epidemiology; Humans; Hypertension/epidemiology; Kidney Neoplasms/epidemiology; Prospective Studies; Risk Factors}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{4}},
  pages        = {{1317--1327}},
  publisher    = {{Oxford University Press}},
  series       = {{International Journal of Epidemiology}},
  title        = {{The relationship between blood pressure and risk of renal cell carcinoma}},
  url          = {{http://dx.doi.org/10.1093/ije/dyac042}},
  doi          = {{10.1093/ije/dyac042}},
  volume       = {{51}},
  year         = {{2022}},
}