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Impact of Hypertension on Pathological Features of Papillary Thyroid Cancer: A Large Sample Single-Center Study


 Background: Hypertension (HTN) is known to increase the risk of thyroid cancer. However, few studies have explored the association between HTN and the prognostic factors of papillary thyroid cancer (PTC). Methods: We retrospectively evaluated PTC patients treated with surgery at our center between January 2017 and September 2020. The association between both HTN and antihypertensive drug use and the clinicopathological features of the PTC patients was analyzed. The odds ratios (OR) were estimated using both univariate and multivariate logistic regression models, which were adjusted for the patients’ age, sex, and thyroid-stimulating hormone level.Results: A total of 2838 patients were enrolled in this study, including 409 patients with HTN. In the multivariate analysis, HTN was associated with larger tumor size [OR = 1.51, 95% confidence interval (CI): 1.10–2.07] and lymph node metastasis (OR = 1.43, 95% CI: 1.02–1.99). There was no statistical difference between females older than 40 years of age and any pathological features, while a positive association between older males and larger tumors (OR=1.87, 95% CI: 1.014-3.45), lymph node metastasis (OR=2.01, 95% CI: 1.08-3.73), and capsule invasion (OR = 1.98, 95% CI: 1.002–3.91). With regard to antihypertensive drug use, the patients taking enzyme inhibitors or angiotensin II-receptor blockers (ACEi/ARB) seemed more likely to develop bilateral PTC comparing ones using calcium channel blockers (CCB) alone, while no statistical difference was found for these taking CCB alone and the combination of CCB and ACEi/ARB. Conclusion: PTC patients with HTN, particularly age >40 males, tend to have invasive features. Antihypertension therapy appears to exert little to no different effect on the pathological characteristics in these patients.