Does hypertension increase mortality risk from lung cancer? A prospective cohort study on smoking, hypertension and lung cancer risk among Korean men.
OBJECTIVE
To examine the effects of hypertension on lung cancer prospectively and to determine the interactive effect of hypertension and smoking on lung cancer risk.


METHODS
A prospective cohort study.


METHODS
The cohort comprised 452,645 Korean men, aged 35-64 years, who received health insurance from the Korea Medical Insurance Corporation and who had biennial medical evaluations in 1992 and 1994.


METHODS
Multivariate Cox proportional hazard models were tested, controlling for age, smoking status, exercise, body mass index, alcohol use, diabetes and serum cholesterol concentration.


METHODS
Deaths from lung cancer.


RESULTS
At baseline, 261 080 persons (58.3%) were identified as current cigarette smokers. Between 1995 and 1999, 883 deaths from lung cancer (44.8/100,000 person-years) occurred. An initial finding indicated that hypertension increased the mortality risk of lung cancer [risk ratio (RR) 1.3, 95% confidence interval (CI) 1.1-1.5]. However, after stratification for smoking status, the risk ratio was increased only for current smokers (RR 1.4, 95% CI 1.2-1.6). When the interaction term was included in the multivariate model, there was a significant interactive effect of hypertension with current smoking (RR 1.8, 95% CI 1.0-3.1) on the risk of death from lung cancer, whereas the effect of hypertension itself did not attain significance.


CONCLUSIONS
Hypertension was not an independent risk factor in lung cancer-related deaths, but it increased the modest risk of lung cancer death among current smokers.
Lee
Soon Young
SY
Department of Preventive Medicine and Public Health, School of Medicine, The Ajou University, Suwon, Korea.
Kim
Miyong T
MT
Jee
Sun Ha
SH
Im
Jeong Soo
JS
D000328:Adult; D001794:Blood Pressure; D015331:Cohort Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007723:Korea / Q000453:epidemiology; D008175:Lung Neoplasms / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects