Blood Pressure and Risk of Cancer Incidence and Mortality in the Metabolic Syndrome and Cancer Project

Abstract

Abstract-Observational studies have shown inconsistent results for the association between blood pressure and cancer risk. We investigated the association in 7 cohorts from Norway, Austria, and Sweden. In total, 577799 adults with a mean age of 44 years were followed for, on average, 12 years. Incident cancers were 22184 in men and 14744 in women, and cancer deaths were 8724 and 4525, respectively. Cox regression was used to calculate hazard ratios of cancer per 10-mmHg increments of midblood pressure, which corresponded with 0.7 SDs and, for example, an increment of systolic/diastolic blood pressure of 130/80 to 142/88 mmHg. All of the models used age as the time scale and were adjusted for possible confounders, including body mass index and smoking status. In men, midblood pressure was positively related to total incident cancer (hazard ratio per 10 mmHg increment: 1.07 [95% CI: 1.04 -1.09]) and to cancer of the oropharynx, colon, rectum, lung, bladder, kidney, malignant melanoma, and nonmelanoma skin cancer. In women, midblood pressure was not related to total incident cancer but was positively related to cancer of the liver, pancreas, cervix, uterine corpus, and malignant melanoma. A positive association was also found for cancer mortality, with HRs per 10-mmHg increment of 1.12 (95% CI: 1.08 -1.15) for men and 1.06 (95% CI: 1.02-1.11) for women. These results suggest a small increased cancer risk overall in men with elevated blood pressure level and a higher risk for cancer death in men and women. ypertension accounts for Ϸ5% of the current global disease burden because of increasing longevity and prevalence of contributing factors, such as obesity, physical inactivity, and an unhealthy diet.1 Increasing age and metabolic aberrations related to obesity, for example, hyperglycemia and hypercholesterolemia, have been linked to increased risk of cancer, 2,3 and several lines of evidence also suggest a link between hypertension and cancer risk.4-8 However, there are only a few observational studies of the association between blood pressure (BP) and cancer incidence and mortality, which show inconsistent findings. 9,10In a meta-analysis based on 10 longitudinal studies of in total 47 119 participants, hypertension was related to a 23% increased risk of cancer mortality, 9 and in another study including 17 498 participants, BP was inversely associated with mortality from leukemia and pancreatic cancer but positively associated with mortality attributed to liver and rectal cancer. 11 The association between hypertension and incident cancer has also been found to differ by cancer site. 10These studies were hampered by small study size and/or lack of information on potential confounders, such as smoking habits and obesity. Moreover, assessment of BP on a single occasion entails a substantial random error attributed to measurement error and within-person variation of BP levels.12,13 Such inaccuracy of exposure assessment dilutes the association with outcome, that is, regression dilution bias. 12,14,15 Risk estimates ...

Hipertensión arterial y tratamiento del cáncer

“…La HTA constituye la comorbilidad más frecuente entre los pacientes con diagnóstico inicial de cán-cer, con una prevalencia que se ha estimado próxima a 40% o mayor en esa población (2)(3)(4) . Asimismo, estudios epidemiológicos recientes ajustados por edad y otras variables han encontrado un riesgo aumentado de cáncer y de mortalidad por esta causa entre los pacientes hipertensos (5,6) .…”

“…La HTA constituye la comorbilidad más frecuente entre los pacientes con diagnóstico inicial de cán-cer, con una prevalencia que se ha estimado próxima a 40% o mayor en esa población (2)(3)(4) . Asimismo, estudios epidemiológicos recientes ajustados por edad y otras variables han encontrado un riesgo aumentado de cáncer y de mortalidad por esta causa entre los pacientes hipertensos (5,6) .La aparición de nuevos casos de HTA o el agravamiento de la misma en quienes ya la padecen es muy común durante el tratamiento del cáncer. En un estudio retrospectivo de más de 25.000 pacientes con varios tipos de cáncer, que registraron una presión arterial (PA) normal al momento del diagnóstico (independientemente de sus anteceden-…”

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

“…For death from cancer specific sites among men, a significant positive association for hypertension was shown for oropharynx, rectum, pancreas, lung, prostate, bladder, and kidney cancers. 36 In the literature there are inconsistent findings about the cancer mortality and incidence associated with hypertension in colon, breast, lung, and prostate cancer. [37][38][39][40][41][42] Further studies are needed to investigate the potential role for high BP in tumor initiation, progression, survival outcomes in lung cancer.…”

A Single Initiating Cause of Hypertension; Potential for Primary Prevention

“…Essential mediators of this step are the matrix metalloproteinases (MMP) (see below). Focal adhesion kinase (FAK) and non-receptor tyrosine kinase (Src) have also been implicated in the adhesion mediated mechanosensitivity [2,22] and both enzymes are also known to be early initiators of EGFR transactivation [22,23]. Also, generation of heparin binding EGF (HB-EGF), through MMP action, causing EGFR transactivation has been shown to be essential for the development of cardiac hypertrophy [24].…”