Exposure to multiple metals and the risk of hypertension in adults: A prospective cohort study in a local area on the Yangtze River, China

• Published in: Environment international Vol. 153; p. 106538
• Main Authors: Zhong, Qi, Wu, Hua-bing, Niu, Qin-shan, Jia, Ping-ping, Qin, Qi-rong, Wang, Xiao-dong, He, Jia-liu, Yang, Wan-jun, Huang, Fen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-08-2021; Elsevier
• Subjects: BKMR analysis; Hypertension; Multiple metals; Yangtze River; Hypertension; Multiple metals; Yangtze River; BKMR analysis
• ISSN: 0160-4120; 1873-6750
• DOI: 10.1016/j.envint.2021.106538

•A cohort study of metals pollution and hypertension on the Yangtze River.•Five metals jointed exposure was positively related to the risk of hypertension.•A significantly positive interaction between cadmium and zinc was observed.•Temporal variability in urinary metal concentrations was examined.
Exposure to multiple metals is recognized as a common and real scenario in daily life. However, limited prospective studies have assessed associations between multiple metals exposure and hypertension.
In total, 2625 adults in a local area on the Yangtze River were investigated at baseline from 2014 to 2015 and followed up in 2019. We measured baseline urine levels of 22 metals and used multivariate logistic analysis and Bayesian kernel machine regression (BKMR) to explore associations between multiple metals exposure and the risk of hypertension.
A total of 385 individuals (29.6%) were diagnosed with hypertension. Five metals (cadmium, copper, magnesium, molybdenum and zinc) were positively associated with hypertension in single-metal models. Cadmium and zinc remained significantly positive associations after adjusting for these five metals, with the odds ratio (OR) in the highest quartiles of 1.49 (95% CI: 1.01, 2.21; p-trend = 0.05) and 1.60 (95% CI: 1.08, 2.38; p-trend = 0.02), respectively. BKMR analysis showed a significant joint effect of multiple metals on hypertension when the concentrations of five metals were at or above their 55th percentile compared with their median values. A potential interaction between cadmium and zinc in increasing the risk of hypertension was observed with the ORint of 1.41 (95%CI: 1.05, 1.89).
We identified the joint effect of multiple metals on hypertension and observed a significant interaction between cadmium and zinc. Further cohort studies are needed to clarify the health effects of multiple metals exposure in a larger population.