Hypertension, diuretics and antihypertensives in relation to bladder cancer

• Published in: Carcinogenesis (New York) 2010-11, Vol.31 (11), p.1964-1971
• Main Authors: Jiang, Xuejuan, Castelao, J.Esteban, Yuan, Jian-Min, Groshen, Susan, Stern, Mariana C., Conti, David V., Cortessis, Victoria K., Coetzee, Gerhard A., Pike, Malcolm C., Gago-Dominguez, Manuela
• Format: Article
• Language: English
• Subjects: Adult; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Asian Continental Ancestry Group; Biological and medical sciences; Blood and lymphatic vessels; Carcinogenesis, carcinogens and anticarcinogens; Cardiology. Vascular system; Case-Control Studies; Diuretics - therapeutic use; Female; Genotype; Glutathione S-Transferase pi - genetics; Glutathione Transferase - genetics; Hemoglobins - metabolism; Humans; Hypertension - drug therapy; Los Angeles - epidemiology; Male; Medical sciences; Middle Aged; Molecular Epidemiology; Nephrology. Urinary tract diseases; Odds Ratio; Prognosis; Risk Factors; Smoking; Tumors; Tumors of the urinary system; Urinary Bladder Neoplasms - epidemiology; Urinary Bladder Neoplasms - genetics; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland
• ISSN: 0143-3334; 1460-2180
• DOI: 10.1093/carcin/bgq173

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.