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Malignant neoplasm related mortality and morbidity of hypertensive outpatients in Japanese men and women.

OBJECTIVES
To investigate the cause of reduced malignant neoplasm-related mortality in hypertensive outpatients.


BACKGROUND
In previous studies, hypertensive outpatients have had modest improvement in overall mortality rate as compared with standard risk groups. While excessive mortality rates for cardiovascular disease and stroke were evident in hypertensive outpatients, the mortality rate of malignant neoplasm was greatly reduced.


METHODS
Using database systems of Sumitomo Life Insurance Co, Japan, standard life tables were generated, and ratios or rates for mortality and morbidity of hypertensive outpatients were extrapolated and analyzed.


RESULTS
The mortality ratio of all cancers was significantly low, 85% (95% CI: 77%-93%), and the morbidity ratio was significantly increased, 121% (95% CI: 109%-133%). The mortality ratio of each of categorized malignant neoplasm was below 100% except for colorectal cancer (111%, 95% CI: 83%-138%). The mortality ratios of stomach cancer (56%, 95% CI: 41%-72%) and liver cancer (52%, 95% CI: 32%-80%) were significantly decreased. The morbidity ratios of colorectal cancer, breast cancer, esophageal cancer, and others were over 100%, and was statistically significant in colorectal cancer (140%, 95% CI: 112%-167%) and others (139%, 95% CI: 113%-165%). The differences between the mortality ratio and the morbidity ratio of stomach cancer and others were statistically significant. The relative lethality of all but pancreatic cancer and leukemia were less than 1.0, and there was a positive correlation between the general prognosis of each cancer and the relative lethality.


CONCLUSIONS
The decreased malignant neoplasm-related mortality ratio in hypertensive outpatients was indicative of an improved prognosis and likely benefited from close medical surveillance.