Hypertension, Antihypertensive Medication Use, and Risk of Renal Cell Carcinoma

• Published in: American journal of epidemiology 1999-03, Vol.149 (6), p.521-530
• Main Authors: Shapiro, Jean A., Williams, Michelle A., Weiss, Noel S., Stergachis, Andy, LaCroix, Andrea Z., Barlow, William E.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; antihypertensive agents; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Biological and medical sciences; blood pressure; carcinoma; Carcinoma, Renal Cell - chemically induced; Case-Control Studies; Confidence Intervals; diuretics; Diuretics - adverse effects; Diuretics - therapeutic use; Female; Health Maintenance Organizations; Humans; hypertension; Hypertension - drug therapy; Kidney Neoplasms - chemically induced; Kidneys; Male; Medical sciences; Middle Aged; Miscellaneous; Nephrology. Urinary tract diseases; Odds Ratio; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; renal cell; Risk; Tumors of the urinary system; Washington
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a009848

To investigate whether diuretic medication use increases risk of renal cell carcinoma (RCC), the authors conducted a case-control study of health maintenance organization members in western Washington State. Cases (n = 238) diagnosed between January 1980 and June 1995 were compared with controls (n = 616) selected from health maintenance organization membership files. The computerized health maintenance organization pharmacy database provided information on medications prescribed after March 1977. Additional exposure information was collected from medical records. For women, use of diuretics was associated with increased risk of RCC (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.0–3.1), but the association was not independent of a diagnosis of hypertension (adjusted for hypertension, OR = 1.1, 95% CI 0.5–2.1). Similarly, nondiuretic antihypertensive use was associated with increased risk, but only when unadjusted for hypertension. For men, neither diuretic nor nondiuretic antihypertensive use was associated with risk of RCC. A diagnosis of hypertension was clearly associated with RCC risk for women (OR = 2.5, 95% CI 1.2–5.1), but not men (OR = 1.3, 95% CI 0.7–2.5). High systolic and diastolic blood pressures were associated with increased risk in both sexes. These results do not support the hypothesis that use of diuretic medication increases RCC risk; they are more consistent with an association between RCC and high blood pressure. Am J Epidemiol 1999;149:521–30.