Hypertension, diuretics and antihypertensives in relation to bladder cancer.
The aim of this study is to investigate the relationships between hypertension, hypertension medication and bladder cancer risk in a population-based case-control study conducted in Los Angeles. Non-Asians between the ages of 25 and 64 years with histologically confirmed bladder cancers diagnosed between 1987 and 1996 were identified through the Los Angeles County Cancer Surveillance Program. A total of 1585 cases and their age-, gender- and race-matched neighborhood controls were included in the analyses. Conditional logistic regression models were used to examine the relationship between history of hypertension, medication use and bladder cancer risk. A history of hypertension was not related to bladder cancer; however, among hypertensive individuals, there was a significant difference in bladder cancer risk related to the use of diuretics or antihypertensive drugs (P for heterogeneity = 0.004). Compared with individuals without hypertension, hypertensive individuals who regularly used diuretics/antihypertensives had a similar risk [odds ratio (OR) 1.06; 95% confidence interval (CI) 0.86-1.30], whereas untreated hypertensive subjects had a 35% reduction in risk (OR: 0.65; 95% CI: 0.48-0.88). A greater reduction in bladder cancer risk was observed among current-smokers (OR: 0.43; 95% CI: 0.27-0.71) and carriers of GSTM1-null (homozygous absence) genotypes (OR: 0.43; 95% CI: 0.22-0.85). Similarly, among smokers with GSTM1-null genotype, levels of 4-aminobiphenyl-hemoglobin adducts were significantly lower among untreated hypertensive individuals (45.7 pg/g Hb) compared with individuals without hypertension (79.8 pg/g Hb) (P = 0.009). In conclusion, untreated hypertension was associated with a reduced risk of bladder cancer.
Jiang
Xuejuan
X
Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Avenue, Los Angeles, CA 90089, USA. xuejuanj@usc.edu
Castelao
J Esteban
JE
Yuan
Jian-Min
JM
Groshen
Susan
S
Stern
Mariana C
MC
Conti
David V
DV
Cortessis
Victoria K
VK
Coetzee
Gerhard A
GA
Pike
Malcolm C
MC
Gago-Dominguez
Manuela
M
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044466:Asian People; D016022:Case-Control Studies; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D051549:Glutathione S-Transferase pi / Q000235:genetics; D005982:Glutathione Transferase / Q000235:genetics; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000235:genetics
D000959:Antihypertensive Agents; D004232:Diuretics; D051549:Glutathione S-Transferase pi; D005982:Glutathione Transferase; D006454:Hemoglobins; C413545:glutathione S-transferase T1; C496556:GSTP1 protein, human