The Association between Blood Pressure Status and Colorectal Polyps in a Taiwanese Population

Abstract

Aim : Colorectal cancer is the third most common cancer worldwide, especially in more developed countries. Colorectal adenomas can progress to malignant carcinoma based on the pathogenesis of adenoma-carcinoma sequence. This study was conducted to investigate the association with colorectal polyps of blood pressure status after excluding the confounding effect of anti-hypertensive agents. MATERIALS AND METHODS : A total of 8,700 eligible subjects with age ≥ 18 years were enrolled from the Health Examination Center of National Cheng Kung University Hospital (NCKUH) between June 2001 and August 2009. We categorized colonoscopic findings into four subgroups: polyp-free, non-neoplastic polyps, non-advanced adenomatous polyps, and advanced adenomatous polyps. Subjects were divided into normal blood pressure, prehypertension and hypertension. RESULTS : The subjects were divided into polyp-free (n = 6,773), non-neoplastic polyps (n = 806), non-advanced adenomatous polyps (n = 876), and advanced adenomatous polyps (n = 245). With adjustments for other variables, hypertension was positively related to non-advanced adenomatous polyps (OR: 1.40, 95% CI: 1.14–1.73) and advanced adenomatous polyps (OR: 1.93, 95% CI: 1.37–2.72). Prehypertension was associated with a higher risk of non-neoplastic polyps (OR: 1.20, 95% CI: 1.01–1.43) and non-advanced adenomatous polyps (OR: 1.42, 95% CI: 1.21–1.68), but not associated with advanced adenomatous polyps. CONCLUSION : Hypertension was positively related to an increased risk of non-advanced and advanced adenomatous polyps, but not non-neoplastic polyps. In contrast, prehypertension was associated with a less advanced stage of colon polyps, including non-neoplastic polyps and non-advanced adenomatous polyps, but not associated with advanced adenomatous polyps.