Evidence map›Paper›PMID 31319002›Full record

ArticleInternational journal of cancer2020

Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition.

Sofia Christakoudi, Artemisia Kakourou, Georgios Markozannes, Ioanna Tzoulaki, Elisabete Weiderpass, Paul Brennan, Marc Gunter, Christina C Dahm, Kim Overvad, Anja Olsen and 38 more

Open access · bronzeAbstract read
In one paragraph

Article in International journal of cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 2 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 98 citations in OpenAlex.

  1. Hypertension and risk of cancer recurrence in adult survivors: A systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Pooled it
  2. Pooled it
  3. High incidence of colorectal cancer in Japanese individuals with hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  4. Urolithiasis in patients with cancer.Nature reviews. Urology · 2026
    Review
  5. Article
  6. Hypertension-cancer recurrence crosstalk: implications for survivorship care.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Changes in blood pressure and metabolic factors of patients after esophagectomy assessed based on a propensity score matching approach.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Review
  14. Review
  15. Article
  16. Article
  17. Current Status and Future Perspective of Onco-Hypertension.American journal of hypertension · 2024
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

48 authors at 20 institutions in 13 countries.

Sofia ChristakoudiDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.ORCID 0000-0001-9219-4436
Artemisia KakourouDepartment of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Georgios MarkozannesDepartment of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Ioanna TzoulakiDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Elisabete WeiderpassInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Paul BrennanInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Marc GunterInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Christina C DahmDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Kim OvervadDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Anja OlsenDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
Anne TjønnelandDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
Marie-Christine Boutron-RuaultCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.ORCID 0000-0002-5956-5693
Anne-Laure MadikaCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
Gianluca SeveriCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
Verena KatzkeDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Tilman KühnDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Manuela M BergmannDepartment of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany.
Heiner BoeingDepartment of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany.
Anna KarakatsaniHellenic Health Foundation, Athens, Greece.
Georgia MartimianakiHellenic Health Foundation, Athens, Greece.
Paschalis ThriskosHellenic Health Foundation, Athens, Greece.
Giovanna MasalaCancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
Sabina SieriEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.ORCID 0000-0001-5201-172X
Salvatore PanicoDipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
Rosario TuminoCancer Registry and Histopathology Department, "M.P. Arezzo" Hospital, ASP, Ragusa, Italy.
Fulvio RicceriDepartment of Clinical and Biological Sciences, University of Turin, Turin, Italy.ORCID 0000-0001-8749-9737
Antonio AgudoUnit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain.
Daniel Redondo-SánchezEscuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, Spain.
Sandra M Colorado-YoharCIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Olatz MokoroaPublic Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain.
Olle MelanderDepartment of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Tanja StocksDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Christel HäggströmDepartment of Biobank Research, Umeå University, Umeå, Sweden.ORCID 0000-0001-6808-4405
Sophia HarlidDepartment of Radiation Sciences, Umeå University, Umeå, Sweden.
Bas Bueno-de-MesquitaDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Carla H van GilsDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.
Roel C H VermeulenDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Kay-Tee KhawUniversity of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom.
Nicholas J WarehamMRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
Tammy Y N TongCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Heinz FreislingInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Mattias JohanssonInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Hannah LennonInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Dagfinn AuneDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Elio RiboliDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Dimitrios TrichopoulosHellenic Health Foundation, Athens, Greece.
Antonia TrichopoulouHellenic Health Foundation, Athens, Greece.
Konstantinos K TsilidisDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Centre international de recherche sur le cancer · FRUniversity of Ioannina · GRHellenic Health Foundation · GRInserm · FRAarhus University · DKGerman Cancer Research Center · DEGerman Institute of Human Nutrition · DELund University · SEUniversity Medical Center Utrecht · NLUniversity of Cambridge · GBAzienda Usl 8 Arezzo · ITBiogipuzkoa Health Research Institute · ESDanish Cancer Society · DKFederico II University Hospital · ITFondazione IRCCS Istituto Nazionale dei Tumori · ITHarvard University · USImperial College London · GBInstitut d'Investigació Biomédica de Bellvitge · ESKing's College London · GBNational and Kapodistrian University of Athens · GR

Funding

Cancer Research UK 14136Cancer Research UK 14136 to EPIC-NorfolkCancer Research UK C570/A16491 to EPIC-OxfordCancer Research UK C8221/A19170 to EPIC-OxfordMedical Research Council G0401527Medical Research Council G1000143Medical Research Council MC_UU_12015/1Medical Research Council MR/N003284/1World Health Organization 001
6 · The paper itself

Abstract

Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP), HR = 1.31 (1.13-1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04-1.12) (SBP), HR = 1.09 (1.01-1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82-1.00) and lymphomas: HR = 0.97 (0.93-1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.

Indexed as

AdultAgedBlood PressureCohort StudiesDietFemaleHumansHypertensionIncidenceMaleMiddle AgedNeoplasmsNutrition AssessmentRisk FactorsassociationcancercohortepidemiologyEuropehypertensionmorphologyrisk factors

Identifiers

PMID31319002
PMCPMC7115826
OpenAlexW2963694764

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.