title: Hypertension and risk of renal cell carcinoma among white and black Americans.
abstract: BACKGROUND
  Renal cell carcinoma and hypertension (a well-established renal cancer risk factor) are both more frequent among blacks than whites in the United States. The association between hypertension and renal cell carcinoma has not been examined in black Americans. We investigated the hypertension-renal cancer association by race, and we assessed the role of hypertension in the racial disparity of renal cancer incidence.
  
  
  METHODS
  Participants were enrolled in a population-based case-control study in Detroit and Chicago during 2002-2007 (number of cases: 843 whites, 358 blacks; number of controls: 707 whites, 519 blacks). Participants reported their history of hypertension and antihypertensive drug use. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for demographic characteristics, smoking, body mass index, and family history of cancer.
  
  
  RESULTS
  Hypertension doubled renal cancer risk (OR = 2.0 [CI = 1.7-2.5]) overall. For whites, the OR was 1.9 (CI = 1.5-2.4), whereas for blacks it was 2.8 (2.1-3.8) (P for interaction = 0.11). ORs increased with time after hypertension diagnosis (P for trend <0.001), reaching 4.1 (CI = 2.3-7.4) for blacks and 2.6 (CI = 1.7-4.1) for whites after 25 years. ORs for poorly controlled hypertension were 4.5 (CI = 2.3-8.8) for blacks and 2.1 (CI = 1.2-3.8) for whites. If these estimates correctly represent causal effects and if, hypothetically, hypertension could be prevented entirely among persons aged 50-79 years, the black/white disparity in renal cancer could be reversed among women and reduced by two-thirds among men.
  
  
  CONCLUSIONS
  Hypertension is a risk factor for renal cancer among both blacks and whites, and might explain a substantial portion of the racial disparity in renal cancer incidence. Preventing and controlling hypertension might reduce renal cancer incidence, adding to the known benefits of blood pressure control for heart disease and stroke reduction, particularly among blacks.
authors: Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7240, USA. coltj@mail.nih.gov
authors: Joanne S
authors: JS
authors: Colt
authors: Kendra
authors: K
authors: Schwartz
authors: Barry I
authors: BI
authors: Graubard
authors: Faith
authors: F
authors: Davis
authors: Julie
authors: J
authors: Ruterbusch
authors: Ralph
authors: R
authors: DiGaetano
authors: Mark
authors: M
authors: Purdue
authors: Nathaniel
authors: N
authors: Rothman
authors: Sholom
authors: S
authors: Wacholder
authors: Wong-Ho
authors: WH
authors: Chow
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data*; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American
chemical_list: D000959:Antihypertensive Agents