title: Antihypertensive medication use and risk of renal cell carcinoma.
abstract: Use of antihypertensive medications has been associated with renal cell carcinoma (RCC), but it is unclear whether specific types of medications increase RCC risk independent of the effect of hypertension, or whether the association varies by histologic subtype. To address this question, we analyzed data from a U.S. population-based case-control study of RCC.
  
  
  
  We collected information on participants' use of drugs to treat hypertension, heart problems, weight control, and swelling. We computed odds ratios (ORs) and 95% confidence intervals (CIs) for each of four major drug classes, separately for participants with (643 cases, 443 controls) and without (500 cases, 718 controls) a history of hypertension, using unconditional logistic and polytomous regression models.
  
  
  
  None of the antihypertensive drug types was associated with RCC overall. Among participants with a history of hypertension, papillary RCC was associated with long-term use of diuretics (OR = 3.1, 95% CI = 1.4-6.7 for 16+ years, 16 cases, 31 controls; P-trend = 0.014) and calcium channel blockers (OR = 2.8, 95% CI = 1.1-7.4 for 16+ years, 8 cases, 14 controls; P-trend = 0.18), while corresponding ORs for clear cell RCC were weaker (ORs 0.9 and 1.5, respectively) and nonsignificant. The only significant finding among those with no hypertension history was an association between calcium channel blockers and papillary RCC (OR = 17.9, 95% CI = 5.9-54.5) that was based on small numbers (8 cases, 9 controls). There was little evidence of an association between RCC and use of ACE inhibitors or beta blockers.
  
  
  
  Our study, while inconclusive for overall RCC, provides, to our knowledge, the first evidence supporting an association between antihypertensive medications and papillary RCC. These subtype-specific findings, although based on small numbers, warrant further investigation.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD, USA. coltjo@verizon.net.
authors.forename: Joanne S
authors.initials: JS
authors.lastname: Colt
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD, USA.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Hofmann
authors.affiliation: Karmanos Cancer Institute and Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
authors.forename: Kendra
authors.initials: K
authors.lastname: Schwartz
authors.affiliation: Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD, USA.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.affiliation: Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, Canada.
authors.forename: Faith
authors.initials: F
authors.lastname: Davis
authors.affiliation: Karmanos Cancer Institute and Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Ruterbusch
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD, USA.
authors.forename: Sonja
authors.initials: S
authors.lastname: Berndt
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007680:Kidney Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: Antihypertensive medications; Case–control study; Hypertension; Renal cell carcinoma