Abdominal obesity, hypertension, antihypertensive medication use and biochemical recurrence of prostate cancer after radical prostatectomy

Eur J Cancer. 2015 Mar;51(5):604-9. doi: 10.1016/j.ejca.2015.01.003. Epub 2015 Jan 19.


Background: The aim of this study was to determine whether abdominal obesity, including visceral adipose tissue (VAT) measured by computed tomography and blood pressure (BP) were associated with biochemical recurrence of prostate cancer after prostatectomy.

Methods: We investigated 283 patients who underwent radical prostatectomy for prostate cancer retrospectively. We obtained information on body mass index (BMI), waist circumference (WC), VAT, BP, antihypertensive drug use, pretreatment prostate-specific antigen levels, pathological Gleason scores and postoperative surgical margin status. Hypertension was defined as systolic BP (SBP)⩾130mmHg or diastolic BP⩾85mmHg.

Results: Among 283 patients, 41 (14%) developed biochemical recurrence subsequently. We performed a Cox proportional hazard regression analysis to assess the association of each obesity measurement and SBP with biochemical recurrence using clinical predictors as potential confounders. No association was observed between any obesity measurement assessed and biochemical recurrence. Adjusting for each of BMI, WC and VAT, a higher SBP was associated significantly with biochemical recurrence (hazard ratio [HR], adjusted for VAT=1.04; 95% confidence interval [CI]=1.02-1.07). Adjusting for obesity (BMI⩾25kg/m(2)), hypertension was also associated significantly with biochemical recurrence (HR=2.08; 95% CI=1.09-3.97). Compared with normotensive patients, those with untreated and uncontrolled hypertension had a significantly increased risk of biochemical recurrence (HR=2.45; 95% CI=1.06-5.66).

Conclusions: A higher BP and untreated, uncontrolled hypertension were independent risk factors for biochemical recurrence after prostatectomy. Control of hypertension could be an important treatment strategy for preventing biochemical recurrence.

Keywords: Abdominal obesity; Antihypertensive agents; Hypertension; Prostate cancer; Prostatectomy; Recurrence.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adiposity
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Body Mass Index
  • Chi-Square Distribution
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Intra-Abdominal Fat / diagnostic imaging
  • Intra-Abdominal Fat / physiopathology
  • Kallikreins / blood*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Recurrence, Local*
  • Neoplasm, Residual
  • Obesity, Abdominal / complications*
  • Obesity, Abdominal / diagnostic imaging
  • Obesity, Abdominal / physiopathology
  • Proportional Hazards Models
  • Prostate-Specific Antigen / blood*
  • Prostatectomy / adverse effects*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Waist Circumference


  • Antihypertensive Agents
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen