Hypertension in long-term survivors of childhood cancer: A nested case-control study

Cardous-Ubbink, M.C.; Geenen, M.M.; Schade, K.J.; Heinen, R.C.; Caron, H.N.; Kremer, L.C.M.; Van Leeuwen, F.E.

doi:10.1016/j.ejca.2010.01.002

« Previous Next »European Journal of Cancer
Volume 46, Issue 4 , Pages 782-790, March 2010

Hypertension in long-term survivors of childhood cancer: A nested case-control study

M.C. Cardous-Ubbink
- Long-Term Follow-Up Clinic, Department of Paediatric Oncology, Emma Kinderziekenhuis AMC, Academic Medical Center, Amsterdam, The Netherlands
M.M. Geenen
- Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands
- Department of Medical Oncology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
K.J. Schade
- Long-Term Follow-Up Clinic, Department of Paediatric Oncology, Emma Kinderziekenhuis AMC, Academic Medical Center, Amsterdam, The Netherlands
R.C. Heinen
- Long-Term Follow-Up Clinic, Department of Paediatric Oncology, Emma Kinderziekenhuis AMC, Academic Medical Center, Amsterdam, The Netherlands
H.N. Caron
- Long-Term Follow-Up Clinic, Department of Paediatric Oncology, Emma Kinderziekenhuis AMC, Academic Medical Center, Amsterdam, The Netherlands
L.C.M. Kremer
- Long-Term Follow-Up Clinic, Department of Paediatric Oncology, Emma Kinderziekenhuis AMC, Academic Medical Center, Amsterdam, The Netherlands
- Corresponding author: Address: Department of Paediatric Oncology, Long-Term Outpatient Clinic (PLEK) F8-166, Emma Kinderziekenhuis AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. Tel.: +31 20 5667132; fax: +31 20 6912231.
F.E. Van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands

Received 11 April 2009; received in revised form 28 December 2009; accepted 6 January 2010. published online 01 February 2010.

Abstract

Aim of the study

To examine risk factors for developing hypertension in childhood cancer survivors (CCS).

Methods

We conducted a nested case-control study of risk for hypertension within a cohort of 1362 childhood cancer survivors treated between 1966 and 1996 in the Emma’s Children’s Hospital/Academic Medical Center in the Netherlands. Detailed information on treatment and several lifestyle factors was collected for 44 cases with hypertension and 123 matched controls. Odds ratios (ORs) for hypertension were calculated by conditional logistic regression analysis.

Results

Body Mass Index (BMI) was the only significant risk factor associated with the occurrence of hypertension (OR 3.95; 95% confidence interval (CI) 1.7–9.1 for BMI⩾25kg/m² compared to BMI<25kg/m²). However, cisplatin, cyclophosphamide and radiotherapy (RT) to the abdominal region were all associated with non-significant risk increases (ORs of 4.3, 2.1, and 1.8, respectively).

Conclusion

Our results show that BMI is the most important risk factor for hypertension following treatment of childhood cancer, emphasising the need for CCS to maintain a normal weight.

Keywords: Childhood cancer, Long-term survival, Long-term side effects, Hypertension, Health outcomes, Late effects, Children, Adolescents