Hypertension among adults exposed to drinking water arsenic in Northern Chile

Abstract

Background A growing number of studies have identified an association between exposure to inorganic arsenic and hypertension. However, results have not been consistent across studies. Additional studies are warranted, given the global prevalence of both arsenic exposure and morbidity attributable to hypertension. Methods We analyzed data collected from October 2007–December 2010 for a population-based cancer case-control study in northern Chile. Data included lifetime individual arsenic exposure estimates and information on potential confounders for a total of 1266 subjects. Those self-reporting either a physician diagnosis of hypertension or use of an anti-hypertensive medication were classified as having hypertension (n=612). The association between hypertension and drinking water arsenic exposure was analyzed using logistic regression models. Results Compared to those in the lowest category for lifetime highest 5-year average arsenic exposure (<60 µg/L), those in the middle (60–623 µg/L) and upper (>623 µg/L) exposure categories had adjusted hypertension ORs of 1.49 (95% CI: 1.09, 2.05) and 1.65 (95% CI: 1.18, 2.32), respectively. Similar results were observed in analyses of lifetime cumulative exposures and analyses restricted to exposures from the distant past. Conclusions We identified evidence of increased odds of hypertension with exposure to arsenic in drinking water among study participants. Our findings add to the growing body of research supporting this association, which could have important public health implications.

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].…”

“…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]. Furthermore, without available maxima values, the width of the highest concentration category was assumed to be equal to the next lowest category [16,25,66,[68][69][70][71][72][73].…”

“…A prospective study conducted in Bangladesh found an increased risk of mortality from ischemic heart disease and cerebrovascular disease in populations exposed to high concentration of inorganic arsenic (iAs) in well water [15]. Similarly, in other studies, increased risk of hypertension [16], stroke [17] and changes in CVD biomarker levels [6,18] were observed associated with As exposure. Among all the adverse health risks from As exposure, CVD is regarded as the most serious noncarcinogenic detrimental health outcome [15,19].…”

Circulating Arsenic is Associated with Long-Term Risk of Graft Failure in Kidney Transplant Recipients: A Prospective Cohort Study

“…Subsequently, diminished kidney clearance of arsenic and enhanced production of reactive oxygen species longitudinally contribute to perpetuate tissue insult and progression of chronic kidney disease [22,23]. Previous studies have also shown an association between arsenic and hypertension and type 2 diabetes mellitus, both suggesting additional mechanisms for secondary kidney damage [44,45]. Ecological studies from the United States, Chile, and Taiwan have shown that arsenic exposure is associated with increased mortality from kidney disease [13][14][15]22,26,28,[46][47][48][49].…”

Urinary Arsenic Species are Detectable in Urban Underserved Hispanic/Latino Populations: A Pilot Study from the Study of Latinos: Nutrition & Physical Activity Assessment Study (SOLNAS)

“…Dietary exposure, including to As, may contribute to CVD and diabetes mortality risk in Hispanics/Latinos [3][4][5][6]. Hispanics/Latinos, who make up >15% of the United States (US) population, experience high mortality rates for cardiovascular disease (CVD) and diabetes [7,8].…”