Key result
A one-standard-deviation increment in diastolic blood pressure measured 10 years before diagnosis was associated with a 20% increased risk of renal cell carcinoma (HR 1.20), whereas systolic blood pressure showed no independent association.
Why the study?
The relation between blood pressure and kidney cancer risk is complex, with discrepant findings across study designs regarding the relative importance of DBP versus SBP.
Does elevated diastolic or systolic blood pressure independently increase the risk of incident renal cell carcinoma?
Cohort (n=701,027)
Yes
Does elevated diastolic or systolic blood pressure independently increase the risk of incident renal cell carcinoma?
Diastolic blood pressure, but not systolic blood pressure, is independently associated with an increased long-term risk of renal cell carcinoma.
Answers are grounded in this paper and cite their sources.
Diastolic BP may flag RCC risk; leaves open causal role and preventive implications in prospective studies.
BACKGROUND: The relation between blood pressure and kidney cancer risk is well established but complex and different study designs have reported discrepant findings on the relative importance of diastolic blood pressure (DBP) and systolic blood pressure (SBP). In this study, we sought to describe the temporal relation between diastolic and SBP with renal cell carcinoma (RCC) risk in detail. METHODS: Our study involved two prospective cohorts: the European Prospective Investigation into Cancer and Nutrition study and UK Biobank, including >700 000 participants and 1692 incident RCC cases. Risk analyses were conducted using flexible parametric survival models for DBP and SBP both separately as well as with mutuality adjustment and then adjustment for extended risk factors. We also carried out univariable and multivariable Mendelian randomization (MR) analyses (DBP: ninstruments = 251, SBP: ninstruments = 213) to complement the analyses of measured DBP and SBP. RESULTS: In the univariable analysis, we observed clear positive associations with RCC risk for both diastolic and SBP when measured ≥5 years before diagnosis and suggestive evidence for a stronger risk association in the year leading up to diagnosis. In mutually adjusted analysis, the long-term risk association of DBP remained, with a hazard ratio (HR) per standard deviation increment 10 years before diagnosis (HR10y) of 1.20 (95% CI: 1.10-1.30), whereas the association of SBP was attenuated (HR10y: 1.00, 95% CI: 0.91-1.10). In the complementary multivariable MR analysis, we observed an odds ratio for a 1-SD increment (ORsd) of 1.34 (95% CI: 1.08-1.67) for genetically predicted DBP and 0.70 (95% CI: 0.56-0.88) for genetically predicted SBP. CONCLUSION: The results of this observational and MR study are consistent with an important role of DBP in RCC aetiology. The relation between SBP and RCC risk was less clear but does not appear to be independent of DBP.
No takes yet. Share an insight, caveat, or question.
Alcala et al. (2022) conducted a cohort in Renal cell carcinoma (n=701,027). Diastolic blood pressure vs. Lower diastolic blood pressure (per standard deviation increment) was evaluated on Incident renal cell carcinoma (measured 10 years before diagnosis, mutually adjusted for systolic blood pressure) (HR 1.20, 95% CI 1.10-1.30). A one-standard-deviation increment in diastolic blood pressure measured 10 years before diagnosis was associated with a 20% increased risk of renal cell carcinoma (HR 1.20), whereas systolic blood pressure showed no independent association.
Synapse has enriched 10 related papers. Consider them for comparative context: