title: 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 >50 μg/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.
authors.affiliation: Centre for Clinical Epidemiology & Biostatistics, The University of Newcastle, New Lambton Heights, NSW, Australia. mdrafiqul.islam@newcastle.edu.au
authors.forename: Mohammad Rafiqul
authors.initials: MR
authors.lastname: Islam
authors.forename: Ismail
authors.initials: I
authors.lastname: Khan
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Sheikh Mohammad Nazmul
authors.initials: SM
authors.lastname: Hassan
authors.forename: Mark
authors.initials: M
authors.lastname: McEvoy
authors.forename: Catherine
authors.initials: C
authors.lastname: D'Este
authors.forename: Syed
authors.initials: S
authors.lastname: Azim
authors.forename: Ayesha
authors.initials: A
authors.lastname: Akhter
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Akter
authors.forename: Sheikh Mohammad
authors.initials: SM
authors.lastname: Shahidullah
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D001459:Bangladesh / Q000453:epidemiology; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D060766:Drinking Water / Q000032:analysis*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D012424:Rural Population; D014874:Water Pollutants, Chemical / Q000633:toxicity*
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic