The relationship between blood pressure and risk of renal cell carcinoma

Karine Alcala, Daniela Mariosa, Karl Smith-Byrne, Dariush Nasrollahzadeh Nesheli, Robert Carreras-Torres, Eva Ardanaz Aicua, Nicola P Bondonno, Catalina Bonet, Mattias Brunström, Bas Bueno-de-Mesquita, María-Dolores Chirlaque, Sofia Christakoudi, Alicia K Heath, Rudolf Kaaks, Verena Katzke, Vittorio Krogh, Börje Ljungberg, Richard M Martin, Anne May, Olle MelanderDomenico Palli, Miguel Rodriguez-Barranco, Carlotta Sacerdote, Tanja Stocks, Anne Tjønneland, Ruth C Travis, Roel Vermeulen, Stephen Chanock, Mark Purdue, Elisabete Weiderpass, David Muller, Paul Brennan, Mattias Johansson

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1317-1327
JournalInternational Journal of Epidemiology
Issue number4
Publication statusPublished - 2022 Aug 10

Bibliographical note

© World Health Organization, 2022. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems
  • Cancer and Oncology

Free keywords

  • Blood Pressure
  • Carcinoma, Renal Cell/epidemiology
  • Humans
  • Hypertension/epidemiology
  • Kidney Neoplasms/epidemiology
  • Prospective Studies
  • Risk Factors

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