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Hypertension, diuretics and antihypertensives in relation to bladder cancer.

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.
AuthorsXuejuan Jiang, J Esteban Castelao, Jian-Min Yuan, Susan Groshen, Mariana C Stern, David V Conti, Victoria K Cortessis, Gerhard A Coetzee, Malcolm C Pike, Manuela Gago-Dominguez
JournalCarcinogenesis (Carcinogenesis) Vol. 31 Issue 11 Pg. 1964-71 (Nov 2010) ISSN: 1460-2180 [Electronic] England
PMID20732908 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
Chemical References
  • Antihypertensive Agents
  • Diuretics
  • Hemoglobins
  • glutathione S-transferase T1
  • GSTP1 protein, human
  • Glutathione S-Transferase pi
  • Glutathione Transferase
  • glutathione S-transferase M1
Topics
  • Adult
  • Antihypertensive Agents (therapeutic use)
  • Asian People
  • 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, genetics)

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