Title: Hypertension, diuretics and antihypertensives in relation to bladder cancer.
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
Published In Carcinogenesis, (2010 Nov)
Abstract: 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.
PubMed ID: 20732908
MeSH Terms: Adult; Antihypertensive Agents/therapeutic use*; Asian Continental Ancestry Group; 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; Middle Aged; Odds Ratio; Prognosis; Risk Factors; Smoking; Urinary Bladder Neoplasms/epidemiology*; Urinary Bladder Neoplasms/genetics