Association between hypertension grades and cancer mortality among Japanese men and women.

Abstract

We aimed to examine the association between hypertension grades and the risk of total and site-specific cancer mortality among Japanese men and women. In the Japan Collaborative Cohort Study, 27,332 participants aged 40-79years were enrolled and followed up with their mortality until 2009. According to the measured blood pressure (BP) at baseline, we classified the participants into four BP categories based on 2018 European guidelines. The Cox proportional hazard models were used to calculate the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) of total and site-specific cancer mortality according to the hypertension category. During the 18.5years of median follow-up, 1,927 cancer deaths were documented. Grade 1 (systolic blood pressure [SBP] 140-159mmHg or diastolic blood pressure [DBP] 90-99mmHg) and grade 2-3 hypertension (SBP ≥ 160mmHg or DBP ≥ 100mmHg) were associated with an increased risk of total cancer mortality; the multivariable HRs were 1.17 (1.04-1.32) for grade 1, and 1.27 (1.09-1.47) for grade 2-3 hypertension compared to optimal and normal BP (SBP < 130mmHg and DBP < 85mmHg). Linear and positive associations were observed between SBP and DBP 10mmHg increment and the risk of total cancer mortality; HRs were 1.06 (1.03-1.08) for SBP and 1.07 (1.02-1.11) for DBP of 10mmHg increment. The excess risk was primarily found for esophageal, liver, and pancreatic cancer; the respective multivariable HRs of grade 2-3 hypertension vs optimal and normal BP were 2.57 (1.10-6.04) for esophageal, 1.67 (1.01-2.77) for liver, and 1.95 (1.17-3.23) for pancreatic cancer. Hypertension was associated with the increased risk of total cancer mortality, primarily of esophageal, liver, and pancreatic cancer.