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

Jessica L. Harding, Manoshayini Sooriyakumaran, Kaarin J. Anstey, Robert Adams, Beverley Balkau, Sharon Brennan-Olsen, Tom Briffa, Timothy M. E. Davis, Wendy A. Davis, Annette Dobson, Graham G. Giles, Janet Grant, Rachel Huxley, Matthew Knuiman, Mary Luszcz, Paul Mitchell, Julie A. Pasco, Christopher M. Reid, David Simmons, Leon A. Simons & 5 others Anne W. Taylor, Andrew Tonkin, Mark Woodward, Jonathan E. Shaw, Dianna J. Magliano

Research output: Contribution to journalArticleResearchpeer-review

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.

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

Keywords

  • antihypertensive treatment
  • cancer
  • cancer mortality
  • hypertension

Cite this

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. / 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.
@article{02107f25cbdf4a699ddb7d0cd5ad27ce,
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; 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.",
keywords = "antihypertensive treatment, cancer, cancer mortality, hypertension",
author = "Harding, {Jessica L.} and Manoshayini Sooriyakumaran and Anstey, {Kaarin J.} and Robert Adams and Beverley Balkau and Sharon Brennan-Olsen and Tom Briffa and Davis, {Timothy M. E.} and Davis, {Wendy A.} and Annette Dobson and Giles, {Graham G.} and Janet Grant and Rachel Huxley and Matthew Knuiman and Mary Luszcz and Paul Mitchell and Pasco, {Julie A.} and Reid, {Christopher M.} and David Simmons and Simons, {Leon A.} and Taylor, {Anne W.} and Andrew Tonkin and Mark Woodward and Shaw, {Jonathan E.} and Magliano, {Dianna J.}",
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doi = "10.1097/HJH.0000000000000770",
language = "English",
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Harding, JL, Sooriyakumaran, M, Anstey, KJ, Adams, R, Balkau, B, Brennan-Olsen, S, Briffa, T, Davis, TME, Davis, WA, 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, 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.

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

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Hypertension, antihypertensive treatment and cancer incidence and mortality

T2 - A pooled collaborative analysis of 12 Australian and New Zealand cohorts

AU - Harding, Jessica L.

AU - Sooriyakumaran, Manoshayini

AU - Anstey, Kaarin J.

AU - Adams, Robert

AU - Balkau, Beverley

AU - Brennan-Olsen, Sharon

AU - Briffa, Tom

AU - Davis, Timothy M. E.

AU - Davis, Wendy A.

AU - Dobson, Annette

AU - Giles, Graham G.

AU - Grant, Janet

AU - Huxley, Rachel

AU - Knuiman, Matthew

AU - Luszcz, Mary

AU - Mitchell, Paul

AU - Pasco, Julie A.

AU - Reid, Christopher M.

AU - Simmons, David

AU - Simons, Leon A.

AU - Taylor, Anne W.

AU - Tonkin, Andrew

AU - Woodward, Mark

AU - Shaw, Jonathan E.

AU - Magliano, Dianna 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; 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.

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; 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.

KW - antihypertensive treatment

KW - cancer

KW - cancer mortality

KW - hypertension

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DO - 10.1097/HJH.0000000000000770

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