title: Drinking water arsenic exposure and blood pressure in healthy women of reproductive age in Inner Mongolia, China.
abstract: The extremely high exposure levels evaluated in prior investigations relating elevated levels of drinking water arsenic and hypertension prevalence make extrapolation to potential vascular effects at lower exposure levels very difficult. A cross-sectional study was conducted on 8790 women who had recently been pregnant in an area of Inner Mongolia, China known to have a gradient of drinking water arsenic exposure. This study observed increased systolic blood pressure levels with increasing drinking water arsenic, at lower exposure levels than previously reported in the literature. As compared to the referent category (below limit of detection to 20 microg of As/L), the overall population mean systolic blood pressure rose 1.29 mm Hg (95% CI 0.82, 1.75), 1.28 mm Hg (95% CI 0.49, 2.07), and 2.22 mm Hg (95% CI 1.46, 2.97) as drinking water arsenic concentration increased from 21 to 50, 51 to 100, and >100 microg of As/L, respectively. Controlling for age and body weight (n=3260), the population mean systolic blood pressure rose 1.88 mm Hg (95% CI 1.03, 2.73), 3.90 mm Hg (95% CI 2.52, 5.29), and 6.83 mm Hg (95% CI 5.39, 8.27) as drinking water arsenic concentration increased, respectively. For diastolic blood pressure effect, while statistically significant, was not as pronounced as systolic blood pressure. Mean diastolic blood pressure rose 0.78 mm Hg (95% CI 0.39, 1.16), 1.57 mm Hg (95% CI 0.91, 2.22) and 1.32 mm Hg (95% CI 0.70, 1.95), respectively, for the overall population and rose 2.11 mm Hg (95% CI 1.38, 2.84), 2.74 mm Hg (95% CI 1.55, 3.93), and 3.08 mm Hg (95% CI 1.84, 4.31), respectively, for the adjusted population (n=3260) at drinking water arsenic concentrations of 21 to 50, 51 to 100, and >100 microg of As/L. If our study results are confirmed in other populations, the potential burden of cardiovascular disease attributable to drinking water arsenic is significant.
authors.affiliation: RTI International, PO Box 12194, 3040 Cornwallis Rd., Research Triangle Park, NC 27709-2194, USA. rkwok@rti.org
authors.forename: Richard K
authors.initials: RK
authors.lastname: Kwok
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.forename: Zhi Yi
authors.initials: ZY
authors.lastname: Liu
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.forename: He Ling
authors.initials: HL
authors.lastname: Ling
authors.forename: Yajuan
authors.initials: Y
authors.lastname: Xia
authors.forename: Danelle
authors.initials: D
authors.lastname: Lobdell
authors.forename: Donglin
authors.initials: D
authors.lastname: Zeng
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: John P
authors.initials: JP
authors.lastname: Creason
authors.forename: Judy L
authors.initials: JL
authors.lastname: Mumford
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001151:Arsenic / Q000633:toxicity*; D001794:Blood Pressure / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011042:Poisons / Q000633:toxicity*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014881:Water Supply
chemical_list: D011042:Poisons; D001151:Arsenic