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Age at incident treatment of hypertension and risk of cancer: a population study

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Abstract

Objective

To determine the effect of treated hypertension on the risk of cancer.

Methods

Population based external comparison study using the Saskatchewan Health databases.

Results

A total of 42,270 subjects were followed for a median of 17.9 years after initiating antihypertensives for hypertension. The effect of hypertension on the risk of cancer varied significantly by age (interaction p < 0.001). Compared with the general population, subjects under 60 years at the time of initiation of antihypertensives had a significantly increased risk of cancer (RR 1.34, 95% CI 1.18–1.52 adjusted for age, sex, and calendar year) while subjects over 60 had a significantly decreased risk (RR 0.88, 95% CI 0.78–0.98). Similar results were obtained for cancer death outcomes. In each subgroup, relative risks across most cancer sites were similar in magnitude and direction. Results were essentially unchanged when analyses were restricted to cancers diagnosed after the first 10 years of follow-up.

Conclusions

The effect of treated hypertension on cancer risk varies by the age at incident treatment of hypertension. These findings are not a result of reverse causality or detection bias. However, they may in part be a consequence of residual confounding and/or reflect the type of hypertension being treated.

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Acknowledgments

This study used data provided by the Saskatchewan Department of Health. The statements contained hereby do not necessarily represent those of the Saskatchewan government. The authors would like to thank Ms. Winanne Downey of the Saskatchewan; Research Services, Population Health Branch, and Karen Robb of the Saskatchewan Cancer Agency, for their expertise and assistance with the data. Sources of funding: This study was funded by an operating grant from the Canadian Institutes of Health Research (CIHR). Dr. Assimes was supported by a training bursary from the Fonds de la Research en santé du Quebec (FRSQ). Dr. Suissa is the recipient of the Distinguished Investigator Award from the Canadian Institutes of Health Research (CIHR). The Pharmacoepidemiology Research Unit is funded by an Équipe grant from the Fonds de la Recherche en Santé du Québec (FRSQ).

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Stanford University School of Medicine, Falk Cardiovascular Research Building, 300 Pasteur Drive, Stanford, CA, 94305-5406, USA

    Themistocles L. Assimes

  2. Division of Clinical Epidemiology, McGill University Health Center, Montreal, QC, Canada

    Samy Suissa

  3. Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada

    Themistocles L. Assimes & Samy Suissa

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  1. Themistocles L. Assimes
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Correspondence to Themistocles L. Assimes.

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Assimes, T.L., Suissa, S. Age at incident treatment of hypertension and risk of cancer: a population study. Cancer Causes Control 20, 1811–1820 (2009). https://doi.org/10.1007/s10552-009-9374-3

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