Association of Hypertension and Blood Pressure With Kidney Cancer Risk: A Nationwide Population-Based Cohort Study

Abstract

Data regarding health behavior-related factors and systolic or diastolic blood pressure to evaluate the association between blood pressure and kidney cancer are lacking. Using nationally representative data from the Korean National Health Insurance System, 9 746 445 participants without kidney cancer between January 1, 2006 and December 31, 2009 were followed up until December 31, 2017 to obtain data regarding cancer incidence. Participants were categorized, according to blood pressure, as normal (<120/80 mm Hg), elevated (120-129/<80 mm Hg), and hypertensive (≥130/80 mm Hg) with or without antihypertensive medication, according to the 2017 American College of Cardiology and American Heart Association blood pressure guidelines. Kidney cancer was noted in 11 083 participants during the 8-year follow-up. Participants with hypertension were at higher risk for kidney cancer than those without hypertension. Participants with hypertension using medication had a higher cancer risk than those not using medication and those with elevated blood pressure. The risk of kidney cancer significantly increased with higher systolic or diastolic blood pressure, in a dose-dependent manner, even after adjusting for antihypertensive medication use. Therefore, hypertension and high systolic or diastolic blood pressure, compared with normal blood pressure, were associated with an increased risk of kidney cancer.

Keywords: blood pressure; body weight; cardiology; hypertension; incidence.

Figure 1.

Flowchart of the study population.

Figure 2.

Kaplan–Meier curve for the crude cumulative 8-year incidence probability of kidney cancer with respect to hypertension (P of Log-rank < 0.001).

Figure 3.

Subgroup analysis of the association between hypertension and kidney cancer in the adjusted Cox-model. Points and bars represent hazard ratio estimates and their associated 95% CIs, respectively. BMI indicates body mass index; CI, confidential interval; and CKD, chronic kidney disease.