Black men are disproportionately burdened by hypertension and prostate cancer (PCa), and some cohorts suggest hypertension is associated with increased PCa risk. We investigated the association of hypertension and antihypertensive use with total (N = 889; 290 Black, 599 White) and fatal (N = 127; 42 Black, 85 White) PCa risk in 6658 (1578 Black, 5080 White) men in the Atherosclerosis Risk in Communities study. In adjusted Cox models, time-updated untreated stage 1 hypertension (systolic/diastolic blood pressure 130-139/80-89 mmHg) was associated with a higher risk of fatal PCa compared to untreated normal blood pressure (hazard ratio (HR) = 1.95; 95% confidence interval (CI) = 1.03-3.70). Compared to untreated normal/elevated blood pressure (combined given few events in those with untreated normal blood pressure), the association was significant in Black (HR = 3.35; 95% CI = 1.27-8.83), but not White (HR = 1.21; 95% CI = 0.58-2.55) men. Ever antihypertensive use was associated with a lower risk of fatal PCa compared to never use (HR = 0.52; 95% CI = 0.31-0.87), including short-term (< 10 years) and long-term (310 years) use (p-trend = 0.02) with similar inverse associations in Black and White men. Hypertension and antihypertensive use were not significantly associated with total PCa. The positive association of untreated stage 1 hypertension and fatal PCa warrants additional confirmation, especially in Black men, and characterization of the underlying mechanism.
Journal of racial and ethnic health disparities. 2023 Dec 15 [Epub ahead of print]
Michael T Marrone, Anna E Prizment, Wanmei Wang, Eldrin Bhanat, Kenneth R Butler, David Couper, Corinne E Joshu, Thomas H Mosley, Elizabeth A Platz, Christian R Gomez
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ., Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA., Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA., Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA., Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA., Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Mind Center, University of Mississippi Medical Center, Jackson, MS, USA.