Medication-Naïve Blood Pressure and Incident Cancers: Analysis of 2 Nationwide Population-Based Databases

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  • Hidehiro Kaneko
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Yuichiro Yano
    YCU Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital , Yokohama , Japan
  • Hyeok-Hee Lee
    Department of Preventive Medicine, Yonsei University College of Medicine , Seoul , Korea
  • Hokyou Lee
    Department of Preventive Medicine, Yonsei University College of Medicine , Seoul , Korea
  • Akira Okada
    Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
  • Hidetaka Itoh
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Kojiro Morita
    Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
  • Akira Fukui
    Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine , Tokyo , Japan
  • Katsuhito Fujiu
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Yuta Suzuki
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Satoshi Matsuoka
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Sunao Nakamura
    Department of Cardiology, New Tokyo Hospital , Matsudo , Japan
  • Nobuaki Michihata
    Department of Health Services Research, The University of Tokyo , Tokyo , Japan
  • Taisuke Jo
    Department of Health Services Research, The University of Tokyo , Tokyo , Japan
  • Norifumi Takeda
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Hiroyuki Morita
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Takashi Yokoo
    Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine , Tokyo , Japan
  • Akira Nishiyama
    Department of Pharmacology, Faculty of Medicine, Kagawa University , Kagawa , Japan
  • Koichi Node
    Department of Cardiovascular Medicine, Saga University , Saga , Japan
  • Anthony J Viera
    Department of Family Medicine and Community Health, Duke University , Durham, North Carolina , USA
  • Paul Muntner
    Department of Epidemiology, University of Alabama at Birmingham , Birmingham, Alabama , USA
  • Suzanne Oparil
    Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama , USA
  • Hyeon Chang Kim
    Department of Preventive Medicine, Yonsei University College of Medicine , Seoul , Korea
  • Hideo Yasunaga
    Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo , Tokyo , Japan
  • Issei Komuro
    Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>BACKGROUND</jats:title> <jats:p>Results of preceding studies on the relationship between blood pressure (BP) and cancers have been confounded due to individuals taking antihypertensive medications or shared risk factors. We assessed whether medication-naïve high BP is a risk factor for incident cancers.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>This retrospective observational study included 1,388,331 individuals without a prior history of cancer and not taking antihypertensive medications enrolled in the JMDC Claims Database between 2005 and 2018. The primary outcome was 16 cancers.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>The median [interquartile range] age was 45 [40–52] years and 56.2% were men. Mean systolic BP (SBP) and diastolic BP (DBP) were 117.7 ± 15.8 and 72.8 ± 11.6 mm Hg. Multivariate Cox regression analysis demonstrated that SBP per 1-SD was associated with a higher incidence of thyroid (hazard ratio [HR]: 1.09, 95% confidence interval [CI]: 1.03–1.16), esophageal (HR: 1.15, 95% CI: 1.07–1.24), colorectal (HR: 1.04, 95% CI: 1.01–1.07), liver (HR: 1.11, 95% CI: 1.03–1.20), and kidney (HR: 1.22, 95% CI: 1.14–1.31) cancers, but with a lower incidence of stomach cancer (HR: 0.94, 95% CI: 0.91–0.98). These associations remained significant after adjustment for multiple testing. DBP was associated with higher incidences of thyroid, esophageal, colorectal, kidney, and corpus uteri cancers, but with a lower incidence of stomach cancer. The associations between SBP and incidences of thyroid, esophageal, colorectal, liver, and kidney cancers were confirmed in the Korean National Health Insurance Service database.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Medication-naïve BP was associated with higher incidences of thyroid, esophageal, colorectal, liver, and kidney cancers. Uncovering the underlying mechanisms for our results may help identify novel therapeutic approach for hypertension and cancer.</jats:p> </jats:sec>

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