高血压及不同基线血压水平与肾癌风险的关联

摘要/Abstract

摘要： 目的探讨高血压及不同基线血压水平对肾癌风险的影响。方法采用前瞻性队列研究的方法,选取首次参与2006-2010年度开滦集团职工健康体检的134β353名既往无肾癌病史、血压数据完整的参与者,以发生肾癌为终点事件,随访至2021年底。根据2018年中国高血压防治指南血压分级标准将参与者分为三组：正常血压组（n=27β228）、正常高值组（n=49β073）、高血压组（n=58β052）。采用多因素Cox比例风险回归模型分析高血压及不同基线血压水平对肾癌发病风险的影响。结果平均随访（13.5±2.74）年,新发肾癌234例,正常血压组、正常高值组、高血压组发病密度分别为53.16/千人年、117.71/千人年、175.81/千人年。Cox 回归分析结果显示,进一步校正年龄、性别等混杂因素后,血压正常高值组与高血压组的HR值（95%CI）分别为：1.891（95%CI,1.153-3.102）和2.084（95%CI,1.248-3.479）,且P均<0.05。结论高血压及基线血压水平升高与肾癌风险增加有关。

关键词: 高血压, 血压水平, 肾癌, 队列研究

周龙飞, 温英武. 高血压及不同基线血压水平与肾癌风险的关联[J]. 心血管病防治知识, 2024, 14(24): 90-96.

参考文献

[1] Hu S S.Report on cardiovascular health and diseases in China 2021: an updated summary[J/OL]. Journal of Geriatric Cardiology, 2023, 20(6): 399-430.
[2] Lewington S, Clarke R, Qizilbash N, et al.Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies[J/OL]. Lancet (London, England), 2002, 360(9349): 1903-1913.
[3] Koene R J, Prizment A E, Blaes A, et al.Shared Risk Factors in Cardiovascular Disease and Cancer[J/OL]. Circulation, 2016, 133(11): 1104-1114.
[4] Hidayat K, Du X, Zou S Y, et al.Blood pressure and kidney cancer risk: meta-analysis of prospective studies[J/OL]. Journal of Hypertension, 2017, 35(7): 1333-1344.
[5] Kim C S, Han K D, Choi H S, et al.Association of Hypertension and Blood Pressure With Kidney Cancer Risk: A Nationwide Population-Based Cohort Study[J/OL]. Hypertension, 2020, 75(6): 1439-1446.
[6] Sanfilippo K M, Mctigue K M, Fidler C J, et al.Hypertension and Obesity and the Risk of Kidney Cancer in 2 Large Cohorts of US Men and Women[J/OL]. Hypertension, 2014, 63(5): 934-941.
[7] Sun L M, Kuo H T, Jeng L B, et al.Hypertension and Subsequent Genitourinary and Gynecologic Cancers Risk: A Population-Based Cohort Study[J/OL]. Medicine, 2015, 94(16): e753.
[8] 中国2型糖尿病防治指南(2020年版)(上)[J/OL].中国2型糖尿病防治指南(2020年版)(上)[J/OL]. 中国实用内科杂志, 2021, 41(8): 668-695.
[9] 诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版)[J]. 中国循环杂志, 2016, 31(10): 937-953.
[10] 中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报, 2004(1): 1-4.
[11] Levey A S, Stevens L A, Schmid C H, et al.A New Equation to Estimate Glomerular Filtration Rate[J]. 2009.
[12] 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1): 24-56.
[13] 彭海艳, 李意芝, 孟利军. 基于数据缺失率和缺失模式的多重插补误差研究[J/OL]. 统计与决策, 2022, 38(1): 20-24.
[14] Harrison D G, Guzik T J, Lob H E, et al.Inflammation, Immunity, and Hypertension[J/OL]. Hypertension, 2011, 57(2): 132-140.
[15] Murray E C, Nosalski R, Macritchie N, et al.Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective[J/OL]. Cardiovascular Research, 2021: cvab330.
[16] Haase V H.Inflammation and hypoxia in the kidney: friends or foes?[J/OL]. Kidney International, 2015, 88(2): 213-215.
[17] De Vivar Chevez A R, Finke J, Bukowski R. The role of inflammation in kidney cancer[J/OL]. Advances in experimental medicine and biology, 2014, 816: 197-234.
[18] Fox P, Hudson M, Brown C, et al.Markers of systemic inflammation predict survival in patients with advanced renal cell cancer[J/OL]. British Journal of Cancer, 2013, 109(1): 147-153.
[19] Kruk L, Mamtimin M, Braun A, et al.Inflammatory Networks in Renal Cell Carcinoma[J/OL]. Cancers, 2023, 15(8): 2212.
[20] Colotta F, Allavena P, Sica A, et al.Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability[J/OL]. Carcinogenesis, 2009, 30(7): 1073-1081.
[21] Montezano A C, Touyz R M.Molecular Mechanisms of Hypertension—Reactive Oxygen Species and Antioxidants: A Basic Science Update for the Clinician[J/OL]. Canadian Journal of Cardiology, 2012, 28(3): 288-295.
[22] Touyz R M, Briones A M.Reactive oxygen species and vascular biology: implications in human hypertension[J/OL]. Hypertension Research, 2011, 34(1): 5-14.
[23] Sosa V, Moliné T, Somoza R, et al.Oxidative stress and cancer: an overview[J/OL]. Ageing research reviews, 2013, 12(1): 376-390.
[24] Rosenberg L.Calcium Channel Blockers and the Risk of Cancer[J/OL]. JAMA, 1998, 279(13): 1000.
[25] Grossman E, Messerli F H, Goldbourt U.Does diuretic therapy increase the risk of renal cell carcinoma?[J/OL]. The American journal of cardiology, 1999, 83(7): 1090-1093.
[26] Daling J R.Calcium channel blockers and cancer: is an association biologically plausible?[J/OL]. American Journal of Hypertension, 1996, 9(7): 713-714.
[27] Ray S D, Kamendulis L M, Gurule M W, et al.Ca²+ antagonists inhibit DNA fragmentation and toxic cell death induced by acetaminophen[J/OL]. FASEB journal: official publication of the Federation of American Societies for Experimental Biology, 1993, 7(5): 453-463.
[28] Gold B, Mirvish S S.N-Nitroso derivatives of hydrochlorothiazide, niridazole, and tolbutamide[J/OL]. Toxicology and Applied Pharmacology, 1977, 40(1): 131-136.
[29] Bangalore S, Kumar S, Kjeldsen S E, et al.Antihypertensive drugs and risk of cancer: network meta-analyses and trial sequential analyses of 324 168 participants from randomised trials[J/OL]. The Lancet Oncology, 2011, 12(1): 65-82.
[30] Colt J S, Hofmann J N, Schwartz K, et al.Antihypertensive medication use and risk of renal cell carcinoma[J/OL]. Cancer Causes & Control, 2017, 28(4): 289-297.
[31] Bukavina L, Bensalah K, Bray F, et al.Epidemiology of Renal Cell Carcinoma: 2022 Update[J/OL]. European Urology, 2022, 82(5): 529-542.
[32] Capitanio U, Bensalah K, Bex A, et al.Epidemiology of Renal Cell Carcinoma[J/OL]. European Urology, 2019, 75(1): 74-84.