title: Higher urinary heavy metal, arsenic, and phthalate concentrations in people with high blood pressure: US NHANES, 2009-2010.
abstract: BACKGROUND
  A link between environmental chemicals and human health has emerged but not complete in risk factors. This work aimed to study the relationships of different sets of urinary environmental chemical concentrations and risk of high blood pressure (BP) in a national, population-based study.
  
  
  METHODS
  Data was retrieved from United States National Health and Nutrition Examination Surveys, 2009-2010, including demographics, BP readings and urinary environmental chemical concentrations. Analyses included t-test and survey-weighted logistic regression models.
  
  
  RESULTS
  Urinary mercury concentrations were not associated with high BP (OR = 1.19, 95% CI 0.97-1.48, p = 0.095). Urinary cobalt (OR = 1.35, 95% CI 1.01-1.81, p = 0.044), lead (OR = 1.77, 95% CI 1.31-2.38, p = 0.001), antimony (OR = 1.37, 95% CI 1.09-1.72, p = 0.010) and tungsten (OR = 1.52, 95% CI 1.27-1.81, p < 0.001) concentrations were observed to increase the risk of high BP. There are no clear associations between environmental parabens and high BP. The effect of environmental bisphenol A (OR = 1.14, 95% CI 1.00-1.30, p = 0.051) disappeared after additionally adjusting for subsample weighting (OR = 1.12, 95% CI 0.93-1.35, p = 0.225). People with higher urinary mono-2-ethyl-5-carboxypentyl phthalate (OR = 1.26, 95% CI 1.00-1.58, p = 0.051), mono-n-butyl phthalate (OR = 1.19, 95% CI 1.01-1.41, p = 0.042) and mono-n-methyl phthalate metabolites (OR = 1.16, 95% CI 1.03-1.32, p = 0.021) tended to have high BP. Moreover, urinary o-phenyl phenol concentrations (OR = 1.49, 95% CI 1.25-1.77, p < 0.001) and dimethylarsonic acid concentrations (OR = 1.35, 95% CI 1.06-1.73, p = 0.019) were also seen to be associated with high BP.
  
  
  CONCLUSIONS
  Urinary environmental chemical concentrations were associated with risk of high BP, although the causal effect cannot be established. Elimination of environmental chemicals in humans would need to be continued.
authors.affiliation: School of the Built Environment, Heriot-Watt University, UK and Owens Institute for Behavioral Research, University of Georgia , USA.
authors.forename: Ivy
authors.initials: I
authors.lastname: Shiue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001151:Arsenic / Q000652:urine*; D015331:Cohort Studies; D004785:Environmental Pollutants / Q000652:urine*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000652:urine*; D016015:Logistic Models; D019216:Metals, Heavy / Q000652:urine*; D008875:Middle Aged; D009749:Nutrition Surveys; D010795:Phthalic Acids / Q000652:urine*; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D019216:Metals, Heavy; D010795:Phthalic Acids; C032279:phthalic acid; D001151:Arsenic
keywords: Blood pressure; chemicals; environmental health; etiology; hypertension; molecular epidemiology; risk factor