Positive association between hypertension and urinary bladder cancer: epidemiologic evidence involving 79,236 propensity score-matched individuals

We hypothesized that hypertensive patients harbor a higher risk of urinary bladder (UB) cancer.

We performed a population-based cohort study on adults using a National Health Insurance Research Database (NHIRD) dataset. Hypertension and comparison non-hypertensive (COMP) groups comprising 39,618 patients each were propensity score-matched by age, sex, index date, and medical comorbidities. The outcome was incident UB cancer validated using procedure codes. We constructed multivariable Cox models to derive adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Cumulative incidence was compared using a log-rank test.

During a total follow-up duration of 380,525 and 372,020 person-years in the hypertension and COMP groups, 248 and 186 patients developed UB cancer, respectively, representing a 32% increase in the risk (aHR, 1.32; 95% CI, 1.09-1.60). Hypertensive women harbored a significantly increased risk of UB cancer (aHR, 1.55; 95% CI, 1.12-2.13) compared with non-hypertensive women, whereas men with hypertension had a statistically non-significant increased risk (aHR, 1.22; 95% CI, 0.96-1.55). The sensitivity analysis demonstrated that the increased risk was sustained throughout different follow-up durations for the entire cohort; a statistical increase in the risk was also noted among hypertensive men.

This nationwide population-based propensity score-matched cohort study supports a positive association between hypertension and subsequent UB cancer development.

Upsala journal of medical sciences. 2018 Jun 18 [Epub ahead of print]

Victor C Kok, Han-Wei Zhang, Chin-Teng Lin, Shih-Chung Huang, Ming-Feng Wu

a Department of Internal Medicine, Division of Medical Oncology , Kuang Tien General Hospital , Taichung , Taiwan (ROC)., c Institute of Population Health Sciences, National Health Research Institutes , Zhunan , Taiwan (ROC)., f Brain Research Center, National Chiao Tung University , Hsinchu , Taiwan (ROC)., h Division of Cardiology, Department of Internal Medicine , Kuang Tien General Hospital , Taichung , Taiwan (ROC)., i Department of Medical Intensive Care Unit , Kuang Tien General Hospital , Taichung , Taiwan (ROC).