title: Association of urinary monomethylated arsenic concentration and risk of hypertension: a cross-sectional study from arsenic contaminated areas in northwestern China.
abstract: BACKGROUND
  Although some studies mainly from Taiwan, Bangladesh and the United States, have suggested a consistent dose-response increase in the prevalence of hypertension with increasing arsenic exposure, the association between chronic environmental arsenic exposure and the risk of hypertension is still inconclusive. Most of the studies discussed the association from the point of view of arsenic concentration in drinking water or cumulative arsenic exposure (CAE), few involved arsenic speciation into the discussion. In this cross-sectional study, we evaluated the potential association between environmental arsenic exposure through drinking water and the prevalence of hypertension by analyzing not only CAE but also urinary arsenic speciation, and provided data on arsenic exposure and hypertension from mainland of China.
  
  
  METHODS
  A cross-sectional study was conducted in one of the arsenic contaminated areas in the northwest of China. Among a total of 1005 residents who voluntarily participated in the study, 604 of eligible subjects were confirmed and interviewed door to door. Standing height, body weight, and blood pressure were measured. First void urine was collected and measured for the concentration of urinary arsenic speciation. CAE was calculated in a subpopulation of 360 subjects with detailed water consumption history. The association between urinary arsenic speciation, CAE and the risk of hypertension were analyzed by multiple logistic regressions.
  
  
  RESULTS
  We found that the levels of urinary arsenic species of inorganic arsenic (iAs), monomethylated arsenic (MMA), dimethylated arsenic (DMA) and total arsenic (tAs) were significantly correlated with systolic or pulse blood pressure. A positive relationship was found between the highest tertile of CAE and hypertension in a dose-dependent manner. Subjects with higher concentration of urinary MMA or lower percentage of DMA tended to be liable to suffer from hypertension. A significant increasing trend of the risk of hypertension with increasing tertiles of MMA concentration was also observed in the logistic regression models both before and after adjustment for confounders.
  
  
  CONCLUSIONS
  Our findings suggested that arsenic exposure, especially high level of CAE, was positively associated with the prevalence of hypertension, and that higher concentration of urinary MMA might be related to the increased susceptibility to hypertension.
authors.affiliation: Department of Environmental and Occupational Health, School of Public Health, China Medical University, No, 92 BeiEr Road, Heping District, Shenyang, Liaoning Province, 110001, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Shuhua
authors.initials: S
authors.lastname: Xi
authors.forename: Quanmei
authors.initials: Q
authors.lastname: Zheng
authors.forename: Da
authors.initials: D
authors.lastname: Wang
authors.forename: Guifan
authors.initials: G
authors.lastname: Sun
mesh_terms: D000328:Adult; D001152:Arsenicals / Q000009:adverse effects* / Q000652:urine; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; 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; D012307:Risk Factors; D014874:Water Pollutants, Chemical / Q000633:toxicity* / Q000652:urine
chemical_list: D001152:Arsenicals; D060766:Drinking Water; D014874:Water Pollutants, Chemical