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

J.L. Harding, M. Sooriyakumaran, K. Anstey, R. Adams, B. Balkau, S. Brennan-Olsen, Tom Briffa, Timothy Davis, Wendy Davis, A. Dobson, G.G. Giles, J. Grant, R. Huxley, Matthew Knuiman, M. Luszcz, P. Mitchell, J.A. Pasco, C.M. Reid, D. Simmons, L.A. Simons & 5 others A.W. Taylor, A. Tonkin, M. Woodward, J.E. Shaw, D.J. Magliano

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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; Ptrend = 0.053 and Ptrend = 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.

Original languageEnglish
Pages (from-to)149-155
Number of pages7
JournalJournal of Hypertension
Volume34
Issue number1
DOIs
Publication statusPublished - Jan 2016

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New Zealand
Antihypertensive Agents
Hypertension
Mortality
Incidence
Neoplasms
Confidence Intervals
Proportional Hazards Models
Observational Studies
Databases

Cite this

Harding, J.L. ; Sooriyakumaran, M. ; Anstey, K. ; Adams, R. ; Balkau, B. ; Brennan-Olsen, S. ; Briffa, Tom ; Davis, Timothy ; Davis, Wendy ; Dobson, A. ; Giles, G.G. ; Grant, J. ; Huxley, R. ; Knuiman, Matthew ; Luszcz, M. ; Mitchell, P. ; Pasco, J.A. ; Reid, C.M. ; Simmons, D. ; Simons, L.A. ; Taylor, A.W. ; Tonkin, A. ; Woodward, M. ; Shaw, J.E. ; Magliano, D.J. / Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts. In: Journal of Hypertension. 2016 ; Vol. 34, No. 1. pp. 149-155.
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title = "Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts",
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; Ptrend = 0.053 and Ptrend = 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.",
author = "J.L. Harding and M. Sooriyakumaran and K. Anstey and R. Adams and B. Balkau and S. Brennan-Olsen and Tom Briffa and Timothy Davis and Wendy Davis and A. Dobson and G.G. Giles and J. Grant and R. Huxley and Matthew Knuiman and M. Luszcz and P. Mitchell and J.A. Pasco and C.M. Reid and D. Simmons and L.A. Simons and A.W. Taylor and A. Tonkin and M. Woodward and J.E. Shaw and D.J. Magliano",
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Harding, JL, Sooriyakumaran, M, Anstey, K, Adams, R, Balkau, B, Brennan-Olsen, S, Briffa, T, Davis, T, Davis, W, Dobson, A, Giles, GG, Grant, J, Huxley, R, Knuiman, M, Luszcz, M, Mitchell, P, Pasco, JA, Reid, CM, Simmons, D, Simons, LA, Taylor, AW, Tonkin, A, Woodward, M, Shaw, JE & Magliano, DJ 2016, 'Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts' Journal of Hypertension, vol. 34, no. 1, pp. 149-155. https://doi.org/10.1097/HJH.0000000000000770

Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts. / Harding, J.L.; Sooriyakumaran, M.; Anstey, K.; Adams, R.; Balkau, B.; Brennan-Olsen, S.; Briffa, Tom; Davis, Timothy; Davis, Wendy; Dobson, A.; Giles, G.G.; Grant, J.; Huxley, R.; Knuiman, Matthew; Luszcz, M.; Mitchell, P.; Pasco, J.A.; Reid, C.M.; Simmons, D.; Simons, L.A.; Taylor, A.W.; Tonkin, A.; Woodward, M.; Shaw, J.E.; Magliano, D.J.

In: Journal of Hypertension, Vol. 34, No. 1, 01.2016, p. 149-155.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts

AU - Harding, J.L.

AU - Sooriyakumaran, M.

AU - Anstey, K.

AU - Adams, R.

AU - Balkau, B.

AU - Brennan-Olsen, S.

AU - Briffa, Tom

AU - Davis, Timothy

AU - Davis, Wendy

AU - Dobson, A.

AU - Giles, G.G.

AU - Grant, J.

AU - Huxley, R.

AU - Knuiman, Matthew

AU - Luszcz, M.

AU - Mitchell, P.

AU - Pasco, J.A.

AU - Reid, C.M.

AU - Simmons, D.

AU - Simons, L.A.

AU - Taylor, A.W.

AU - Tonkin, A.

AU - Woodward, M.

AU - Shaw, J.E.

AU - Magliano, D.J.

PY - 2016/1

Y1 - 2016/1

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; Ptrend = 0.053 and Ptrend = 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; Ptrend = 0.053 and Ptrend = 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.

U2 - 10.1097/HJH.0000000000000770

DO - 10.1097/HJH.0000000000000770

M3 - Article

VL - 34

SP - 149

EP - 155

JO - Journal of Hypertension.

JF - Journal of Hypertension.

SN - 0263-6352

IS - 1

ER -