ORIGINAL PAPERS: Therapeutic aspectsSpironolactone and the risk of urinary tract cancer in patients with hypertension a nationwide population-based retrospective case–control studyChuang, Ya-Wen; Yu, Mei-Ching; Huang, Shih-Ting; Yang, Cheng-Kuang; Chen, Cheng-Hsu; Lo, Ying-Chih; Lin, Cheng-Li; Shu, Kuo-Hsiung; Yu, Tung-Min; Kao, Chia-HungAuthor Information aDivision of Nephrology, Taichung Veterans General Hospital, Taichung bDepartment of Pediatric Nephrology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan cDivision of Urology, Taichung Veterans General Hospital dManagement Office for Health Data, China Medical University Hospital eCollege of Medicine, China Medical University fGraduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University gDepartment of Nuclear Medicine and PET Center, China Medical University Hospital hDepartment of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan Correspondence to Professor Chia-Hung Kao, MD, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University; No. 2, Yuh-Der Road, Taichung 404, Taiwan. Tel: +886 4 22052121, ext. 7412; fax: +886 4 22336174; e-mail: firstname.lastname@example.org Abbreviations: ACEI, angiotensin-converting enzyme inhibitors; ATC, anatomical therapeutic chemical; AIIRB, angiotensin II receptor blockers; anti-HTNs, antihypertensive medications; AT2R, angiotensin II type 2 receptor; CCBs, calcium channel blockers; CI, confidence interval; CKD, chronic kidney disease; HDR, homology-directed repair; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; NHIRD, National Health Insurance Research Database; OR, odds ratio; RAAS, renin–angiotensin–aldosterone system; RCIPD, Registry of Catastrophic Illness Patient Database; UTCs, urinary tract cancers Received 10 April, 2016 Revised 15 August, 2016 Accepted 3 September, 2016 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com). Journal of Hypertension: January 2017 - Volume 35 - Issue 1 - p 170-177 doi: 10.1097/HJH.0000000000001130 Buy SDC Metrics Abstract Aim: This was a nationwide study by National Health Insurance Research Database to investigate the risk of urinary tract cancers (UTCs) for renin–angiotensin–aldosterone system inhibitors including spironolactone. Methods: A total of 32 167 UTC patients with hypertension were enrolled in the National Health Insurance program between 2005 and 2011. Results: Among different subclasses of renin–angiotensin–aldosterone system inhibitors, the adjusted odds ratio (OR) for UTC risk was 1.00 [95% confidence interval (CI) = 0.96–1.04] in angiotensin-converting enzyme inhibitors, 1.22 (95% CI = 1.18–1.26) in patients who received angiotensin II receptor blockers, 0.91 (95% CI = 0.87–0.96) in spironolactone. Spironolactone is associated with a significantly lower risk of prostate cancer (adjusted OR = 0.88, 95% CI = 0.82–0.94) in the male patients. A similar trend was observed in the female patients for the risk of bladder cancer (adjusted OR = 0.81, 95% CI = 0.72–0.92). Conclusion: Our findings show that a lower risk of UTCs significantly associated with spironolactone in patients. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.