Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China

Abstract

BackgroundEnvironmental exposure to multiple metals have been inconsistently associated with hypertension. Obesity is an important independent risk factor for hypertension, and few studies have assessed the interaction between obesity and metals in this context. We aimed to clarify their association and interaction.MethodsThis cross-sectional study included 3,063 adults from 11 districts or counties, Guangdong. We measured the whole blood levels of 13 metals and used multipollutant-based statistical methods to analyze the association of metals with hypertension. The interaction between metals and obesity on hypertension was assessed on additive and multiplicative scales.ResultsFour metals (manganese, arsenic, cadmium, and lead) were significantly associated with hypertension risk, five metals (manganese, zinc, arsenic, cadmium, and lead) were related to elevated SBP levels, five metals (manganese, zinc, selenium, cadmium, and lead) were associated with elevated DBP levels in single-metal model. Manganese remained significantly related to hypertension risk [odds ratio, 1.35 (1.02–1.78)] after adjusting for these four metals. Significant positive dose-response relationships between manganese, arsenic, cadmium, lead and hypertension risk were observed (P for overall < 0.001, P for non-linearity > 0.05). Compared with those in the lowest quartile, participants in the highest manganese quartile had a 2.83 mmHg (95% Cl: 0.71–4.96) (PFDR = 0.040) higher level of SBP. Individuals in the highest quartiles of zinc and lead had a 1.45 mmHg (0.10–2.81) (PFDR = 0.033) and 2.06 mmHg (0.59–3.53) (PFDR = 0.020) higher level of DBP, respectively. The negative interactions between cadmium, lead and obesity influences hypertension risk. BKMR analysis showed a significant joint effect of manganese, arsenic, cadmium and lead on hypertension when the concentrations of four metals were at or above their 55th percentile compared to their median values.ConclusionsThe combined effect of four metals (manganese, arsenic, cadmium and lead) were associated with the prevalence of hypertension. Potential interaction effects of cadmium, lead and obesity on hypertension risk may exist. Further cohort studies in larger population are needed to clarify these findings.

Leukocyte Telomere Length Mediates the Associations between Blood Lead and Cadmium with Hypertension among Adults in the United States: A Cross-Sectional Study

“…The findings of this study are in line with earlier research on the connection between exposure to lead and cadmium and hypertension. Wu et al declared that blood lead and cadmium had positive relationships with hypertension risk and also with diastolic and systolic pressure [ 34 ]. According to a study utilizing the NHANES 1999–2018 database, hypertension prevalence rose by 12% in the group with the highest blood lead concentration quartiles compared that with the lowest quartiles [ 35 ].…”

Evidence Linking Cadmium Exposure and β2-Microglobulin to Increased Risk of Hypertension in Diabetes Type 2

“…Of note, blood Cd levels ≥ 0.4 µg/L were found to be associated with 1.5-fold to 2.4-fold increases in risk of hypertension among Caucasian and Mexican-American women enrolled in the U.S. National Health and Nutrition Examination Survey (NHANES) 1999–2006 ( n = 16,222) [ 4 ]. Studies from other countries, including Korea [ 6 ], China [ 7 , 8 ], Canada [ 9 ] and Japan [ 10 ] have also linked Cd exposure indices (blood, serum or urinary Cd) to an increased risk of hypertension.…”

“…Hypertension is defined as systolic blood pressure ≥ 140 mmHg, or diastolic blood pressure ≥90 mmHg, and is both a cause and a consequence of chronic kidney disease (CKD) [ 1 , 2 , 3 ]. An increased risk of hypertension has been linked to environmental exposure to cadmium (Cd), a widespread metal pollutant, in the general population in many countries, including the U.S. [ 4 , 5 ], Korea [ 6 ], China [ 7 , 8 ], Canada [ 9 ], Japan [ 10 ], and Thailand [ 11 ]. A cross-sectional study of the U.S. population observed an increased risk of hypertension in Caucasian and Mexican-American women who had blood Cd levels ≥0.4 µg/L [ 4 ].…”