Peeters P H, van Noord P A, Hoes A W, Grobbee D E
Julius Center for Patient-Oriented Research, Utrecht University, Medical School, Medical Hospital, The Netherlands.
J Hypertens. 1998 Jul;16(7):941-7. doi: 10.1097/00004872-199816070-00007.
To investigate whether hypertension and the use of antihypertensive drugs are associated with mortality from cancer among women.
A prospective study of 11075 women living in Utrecht, the Netherlands, aged 50-65 years at enrolment in a breast cancer screening project (DOM cohort). Women attended screening rounds between 1974 and 1985, during which blood pressure measurements were taken and information on drug use and smoking was ascertained. Since 1974 (median follow-up time 19 years) information on cause of death has been obtained from the patient's general practitioner. Hypertension was defined as a systolic blood pressure > 160 mmHg, a diastolic blood pressure > 95 mmHg, or current use of antihypertensive drugs. Cox regression analysis was used to investigate the association between hypertension (treated and untreated) and total and site-specific mortalities from cancer. The influences of systolic and diastolic blood pressures per 10 mmHg increase for women not using antihypertensive drugs were evaluated. Analyses were adjusted for age, smoking, and body mass index.
In total, 704 women died of cancer and 1633 women left the study area. Hypertensive women had a greater than normal (not statistically significant) total risk of mortality from cancer [hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.93-1.31]. Risks for treated and untreated hypertensive women were similar. Cancer-site-specific analyses revealed a statistically significantly lower mortality from gastrointestinal cancers among untreated hypertensive women (HR 0.64, 95% CI 0.44-0.93), whereas mortality from lung cancer was more prevalent among these women (HR 2.50, 95% CI 1.37-4.59). Mortality from lymphatic and hematopoietic cancers for drug-treated hypertensive women was greater than normal (HR 2.11, 95% CI 1.04-4.28), as was mortality from cancers of the uterus, cervix, and ovary (HR 1.80, 95% CI 1.00-3.26).
These results support the hypothesis that, if there is a link between blood pressure and cancer, it is likely to be positive and relatively small (+10%); and applies also to nondrug-treated women. The relation may apply for some types of cancer, but not for others.
调查高血压及降压药物的使用是否与女性癌症死亡率相关。
对荷兰乌得勒支市11075名年龄在50 - 65岁之间、参加乳腺癌筛查项目（DOM队列）的女性进行前瞻性研究。这些女性在1974年至1985年期间参加筛查，期间测量血压，并确定药物使用和吸烟情况。自1974年起（中位随访时间19年），从患者的全科医生处获取死亡原因信息。高血压定义为收缩压>160 mmHg、舒张压>95 mmHg或正在使用降压药物。采用Cox回归分析来研究高血压（治疗和未治疗）与癌症总死亡率及特定部位死亡率之间的关联。评估了未使用降压药物的女性收缩压和舒张压每升高10 mmHg的影响。分析对年龄、吸烟和体重指数进行了校正。
共有704名女性死于癌症，1633名女性离开研究区域。高血压女性的癌症总死亡风险高于正常水平（无统计学意义）[风险比（HR）1.10，95%置信区间（CI）0.93 - 1.31]。治疗和未治疗的高血压女性风险相似。特定癌症部位分析显示，未治疗的高血压女性胃肠道癌症死亡率在统计学上显著较低（HR 0.64，95% CI 0.44 - 0.93），而这些女性肺癌死亡率更高（HR 2.50，95% CI 1.37 - 4.59）。接受药物治疗的高血压女性淋巴和造血系统癌症死亡率高于正常水平（HR 2.11，95% CI 1.04 - 4.28），子宫、宫颈和卵巢癌症死亡率也是如此（HR 1.80，95% CI 1.00 - 3.26）。
这些结果支持以下假设，即如果血压与癌症之间存在联系，那么这种联系可能是正向的且相对较小（+10%）；并且这也适用于未接受药物治疗的女性。这种关系可能适用于某些类型的癌症，但不适用于其他类型。
