Hisamatsu Takashi, Kadota Aya, Hayakawa Takehito, Kita Yoshikuni, Harada Akiko, Okami Yukiko, Kondo Keiko, Ohkubo Takayoshi, Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu, Miura Katsuyuki
Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan.
Hypertens Res. 2024 Jan;47(1):206-214. doi: 10.1038/s41440-023-01497-3. Epub 2023 Nov 22.
Onco-hypertension has been proposed, although associations of high blood pressure (BP) with cancer risk remain inconsistent. We examined associations of high BP with risk of mortality from stomach, lung, colorectal, liver, and pancreatic cancers independent of possible confounders in an analysis that excluded deaths within the first 5 years of follow-up to consider the reverse causality. In a prospective cohort representative of the general Japanese population (1980-2009), we studied 8088 participants (mean age, 48.2 years; 56.0% women) without clinical cardiovascular disease or antihypertensive medication at baseline. Fine-Gray competing risks regression was used to estimate hazard ratios for 10 mmHg higher BP adjusted for confounders including smoking, alcohol-drinking, obesity, and diabetes mellitus. During 29-year follow-up, 159 (2.0%), 159 (2.0%), 89 (1.1%), 86 (1.1%), and 68 (0.8%) participants died from stomach, lung, colorectal, liver, and pancreatic cancers, respectively. We observed a positive association of high BP with risk of colorectal cancer mortality but not with mortality risks from any other cancers. The association with colorectal cancer mortality for systolic and diastolic BP was evident in those aged 30-49 years (hazard ratios 1.43 [95% confidence interval, 1.22-1.67] and 1.86 [1.32-2.62], respectively) but not in those aged 50-59 years and ≥60 years (P for age interaction <0.01 for systolic and diastolic BP). The associations with colorectal cancer mortality were similar in the analyses stratified by smoking, alcohol-drinking, obesity, and diabetic status. In conclusion, high BP among young to middle-aged adults was independently associated with risk of colorectal cancer mortality later in life.
虽然高血压与癌症风险之间的关联仍不一致，但有人提出了肿瘤性高血压这一概念。我们在一项分析中，排除随访前5年内的死亡病例以考虑反向因果关系，研究了高血压与胃癌、肺癌、结直肠癌、肝癌和胰腺癌死亡风险之间的关联，且不受可能的混杂因素影响。在一个代表日本普通人群的前瞻性队列研究（1980 - 2009年）中，我们研究了8088名参与者（平均年龄48.2岁；56.0%为女性），这些参与者在基线时无临床心血管疾病或未服用抗高血压药物。采用Fine - Gray竞争风险回归模型来估计血压每升高10 mmHg的风险比，并对包括吸烟、饮酒、肥胖和糖尿病等混杂因素进行了校正。在29年的随访期间，分别有159名（2.0%）、159名（2.0%）、89名（1.1%）、86名（1.1%）和68名（0.8%）参与者死于胃癌、肺癌、结直肠癌、肝癌和胰腺癌。我们观察到高血压与结直肠癌死亡风险呈正相关，但与其他任何癌症的死亡风险均无关联。收缩压和舒张压与结直肠癌死亡的关联在30 - 49岁人群中显著（风险比分别为1.43 [95%置信区间，1.22 - 1.67]和1.86 [1.32 - 2.62]），而在50 - 59岁和≥60岁人群中不显著（收缩压和舒张压的年龄交互作用P值均<0.01）。在按吸烟、饮酒、肥胖和糖尿病状态分层的分析中，与结直肠癌死亡的关联相似。总之，中青年成年人的高血压与晚年结直肠癌死亡风险独立相关。
