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Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition
Author(s) -
Christakoudi Sofia,
Kakourou Artemisia,
Markozannes Georgios,
Tzoulaki Ioanna,
Weiderpass Elisabete,
Brennan Paul,
Gunter Marc,
Dahm Christina C.,
Overvad Kim,
Olsen Anja,
Tjønneland Anne,
BoutronRuault MarieChristine,
Madika AnneLaure,
Severi Gianluca,
Katzke Verena,
Kühn Tilman,
Bergmann Manuela M.,
Boeing Heiner,
Karakatsani Anna,
Martimianaki Georgia,
Thriskos Paschalis,
Masala Giovanna,
Sieri Sabina,
Panico Salvatore,
Tumino Rosario,
Ricceri Fulvio,
Agudo Antonio,
RedondoSánchez Daniel,
ColoradoYohar Sandra M.,
Mokoroa Olatz,
Melander Olle,
Stocks Tanja,
Häggström Christel,
Harlid Sophia,
BuenodeMesquita Bas,
Gils Carla H.,
Vermeulen Roel C.H.,
Khaw KayTee,
Wareham Nicholas J.,
Tong Tammy Y.N.,
Freisling Heinz,
Johansson Mattias,
Len Hannah,
Aune Dagfinn,
Riboli Elio,
Trichopoulos Dimitrios,
Trichopoulou Antonia,
Tsilidis Konstantinos K.
Publication year - 2019
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32576
Subject(s) - medicine , european prospective investigation into cancer and nutrition , prospective cohort study , cancer , lung cancer , hazard ratio , uterine cancer , blood pressure , cervical cancer , adenocarcinoma , body mass index , oncology , confidence interval
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.