@article{3077673,
    title = "Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition",
    author = "Christakoudi, S. and Kakourou, A. and Markozannes, G. and Tzoulaki, I. and Weiderpass, E. and Brennan, P. and Gunter, M. and Dahm, C.C. and Overvad, K. and Olsen, A. and Tjønneland, A. and Boutron-Ruault, M.-C. and Madika, A.-L. and Severi, G. and Katzke, V. and Kühn, T. and Bergmann, M.M. and Boeing, H. and Karakatsani, A. and Martimianaki, G. and Thriskos, P. and Masala, G. and Sieri, S. and Panico, S. and Tumino, R. and Ricceri, F. and Agudo, A. and Redondo-Sánchez, D. and Colorado-Yohar, S.M. and Mokoroa, O. and Melander, O. and Stocks, T. and Häggström, C. and Harlid, S. and Bueno-de-Mesquita, B. and van Gils, C.H. and Vermeulen, R.C.H. and Khaw, K.-T. and Wareham, N.J. and Tong, T.Y.N. and Freisling, H. and Johansson, M. and Lennon, H. and Aune, D. and Riboli, E. and Trichopoulos, D. and Trichopoulou, A. and Tsilidis, K.K.",
    journal = "International Journal  of Cancer",
    year = "2020",
    volume = "146",
    number = "10",
    pages = "2680-2693",
    publisher = "Wiley-Liss, Inc.",
    issn = "0020-7136",
    doi = "10.1002/ijc.32576",
    keywords = "adult;  age;  aged;  Article;  blood pressure;  body mass;  breast cancer;  cancer localization;  cancer risk;  cohort analysis;  colon cancer;  controlled clinical trial;  controlled study;  diabetes mellitus;  diastolic blood pressure;  diet;  disease association;  education;  endometrium carcinoma;  esophageal adenocarcinoma;  esophageal squamous cell carcinoma;  European;  female;  follow up;  gender;  hazard ratio;  head and neck cancer;  human;  hypertension;  lymphoma;  major clinical study;  male;  malignant neoplasm;  multicenter study;  nutrition;  physical activity;  postmenopause;  priority journal;  proportional hazards model;  prospective study;  renal cell carcinoma;  reproduction;  risk assessment;  smoking;  squamous cell lung carcinoma;  squamous cell skin carcinoma;  systolic blood pressure;  uterine endometroid cancer;  blood pressure;  complication;  incidence;  middle aged;  neoplasm;  nutritional assessment;  risk factor, Adult;  Aged;  Blood Pressure;  Cohort Studies;  Diet;  Female;  Humans;  Hypertension;  Incidence;  Male;  Middle Aged;  Neoplasms;  Nutrition Assessment;  Risk Factors",
    abstract = "Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08–1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14–1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07–1.26) (SBP), HR = 1.31 (1.13–1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04–1.12) (SBP), HR = 1.09 (1.01–1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82–1.00) and lymphomas: HR = 0.97 (0.93–1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies. © 2019 UICC"
}