Systolic and diastolic blood pressure, prostate cancer risk, treatment, and survival. The PROCA-life study

Einar Stikbakke; Henrik Schirmer; Tore Knutsen; Martin Støyten; Tom Wilsgaard; Edward L Giovannucci; Anne McTiernan; Anne E Eggen; Hege S Haugnes; Elin Richardsen; Inger Thune

doi:10.1002/cam4.4523

Systolic and diastolic blood pressure, prostate cancer risk, treatment, and survival. The PROCA-life study

Cancer Med. 2022 Feb;11(4):1005-1015. doi: 10.1002/cam4.4523. Epub 2021 Dec 22.

Authors

Einar Stikbakke^{1

2}, Henrik Schirmer^{3

4}, Tore Knutsen^{1

5}, Martin Støyten^{1

2}, Tom Wilsgaard⁶, Edward L Giovannucci^{7

8}, Anne McTiernan^{9

10}, Anne E Eggen⁶, Hege S Haugnes^{1

2}, Elin Richardsen^{11

12}, Inger Thune^{1

13

14}

Affiliations

¹ Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
² Department of Oncology, University Hospital of North Norway, Tromsø, Norway.
³ Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
⁴ Institute of Clinical Medicine Campus Ahus, University of Oslo, Oslo, Norway.
⁵ Department of Urology, University Hospital of North Norway, Tromsø, Norway.
⁶ Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
⁷ Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
⁸ Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
⁹ Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
¹⁰ Department of Epidemiology, School of Public Health, and Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA.
¹¹ Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
¹² Department of Pathology, University Hospital of North Norway, Tromsø, Norway.
¹³ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
¹⁴ Department of Oncology, The Cancer Centre, Ullevaal, Oslo University Hospital, Oslo, Norway.

Abstract

Background: Inflammation has been linked to prostate cancer and hypertension, but it remains equivocal whether elevated blood pressure (BP) influence prostate cancer risk and survival.

Method: Using Cox regression models, we examined the association between prediagnostic BP and prostate cancer risk among 12,271 men participating in the Prostate Cancer throughout life (PROCA-life) study. Systolic and diastolic BP were measured. A total of 811 men developed prostate cancer, and followed for additional 7.1 years, and we studied the association between prediagnostic BP and overall mortality among patients with prostate cancer.

Results: Men (>45 years) with a systolic BP >150 mmHg had a 35% increased risk of prostate cancer compared with men with a normal systolic BP (<130 mmHg) (HR 1.35, 95% CI 1.08-1.69). Among patients with prostate cancer, men with systolic BP >150 mmHg had a 49% increased overall mortality compared with men with a normal systolic BP (HR 1.49, 1.06-2.01). Among patients with prostate cancer treated with curative intent, those with a high diastolic BP (>90 mmHg) had a threefold increase in overall mortality risk (HR 3.01, 95% CI 1.40-6.46) compared with patients with a normal diastolic BP (<80 mmHg).

Conclusion: Our results support that systolic and diastolic BP are important factors when balancing disease management in patients with prostate cancer.

Keywords: hypertension; inflammation; mortality; prostate cancer; risk.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Pressure / physiology
Humans
Hypertension*
Male
Proportional Hazards Models
Prostatic Neoplasms* / therapy
Systole