Hypertension, antihypertensive medication use, and risk of renal cell carcinoma

To investigate whether diuretic medication use increases risk of renal cell carcinoma (RCC), the authors conducted a case-control study of health main tenance organization members in western Washington State. Cases (n = 238) d iagnosed between January 1980 and June 1995 were compared with controls (n = 616) selected from health maintenance organization membership files. The computerized health maintenance organization pharmacy database provided inf ormation on medications prescribed after March 1977. Additional exposure in formation was collected from medical records. For women, use of diuretics w as associated with increased risk of RCC (odds ratio (OR) = 1.8, 95% confid ence interval (CI) 1.0-3.1), but the association was not independent of a d iagnosis of hypertension (adjusted for hypertension, OR = 1.1, 95% CI 0.5-2 .1). Similarly, nondiuretic antihypertensive use was associated with increa sed risk, but only when unadjusted for hypertension. For men, neither diure tic nor nondiuretic antihypertensive use was associated with risk of RCC. A diagnosis of hypertension was clearly associated with RCC risk for women ( OR = 2.5, 95% CI 1.2-5.1), but not men (OR = 1.3, 95% CI 0.7-2.5). High sys tolic and diastolic blood pressures were associated with increased risk in both sexes. These results do not support the hypothesis that use of diureti c medication increases RCC risk; they are more consistent with an associati on between RCC and high blood pressure.