Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh

Abstract

Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1–8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46–8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41–19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.

Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis

“…In this analysis, we assumed both a constant log-linear (log-transformed water As concentration) and a flexible non-linear (restricted cubic splines with knots at the 10th, 50th and 90th percentiles of log-transformed water As concentration) associations. The median value was assigned as the concentration level for each concentration category and if the median value was not provided directly, the mean or the midpoint values were calculated instead [16,25,45,59,63,[66][67][68][69][70][71][72][73][74][75]. For the calculation of the midpoint value for each concentration category, zero was used as the minimum if not available [16,25,66,[68][69][70][71][72][73].…”

Arsenic causes aortic dysfunction and systemic hypertension in rats: Augmentation of angiotensin II signaling

“…Several studies have associated high-level of arsenic exposure from drinking water with elevated risk of vascular diseases, including peripheral vascular disease, hypertension, ischemic heart disease and carotid atherosclerosis [6]. Epidemiological studies reported increased incidence of hypertension in arsenic-exposed populations [7][8][9]. Further, evidences showed that arsenic induced hypertension in rats [10,11] and mice [12].…”

Ground Water Arsenic Contamination and Its Health Effects in Bangladesh

“…Studies conducted on a Bangladesh population had demonstrated increased occurrence of hypertension, diabetes mellitus, and chronic respiratory disorders in terms of chronic cough and asthma among arsenicosis patients compared to those having no exposure to arsenic [17][18][19][62][63][64][65]. Studies revealed (Table 2-7) that the crude prevalence ratio for diabetes mellitus among arsenicosis patients was 4.4 (95%, CI 2.5-7.7).…”