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Int. J. Environ. Res. Public Health 2012, 9(12), 4522-4536; doi:10.3390/ijerph9124522

Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh

1 Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia 2 Department of Pharmacology, Dhaka Medical College, Dhaka 1000, Bangladesh 3 Department of Public Health, Atish Dipankar University of Science & Technology, Dhaka 1205, Bangladesh 4 School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia 5 Department of Obstetrics and Gynaecology, Tairunnessa Memorial Medical College, Targas, Kunia, Gazipur, Dhaka, Gazipur 1701, Bangladesh 6 Department of Paediatrics, Institute of Child and Mother Health (ICMH), Matuail, Demra, Dhaka 1362, Bangladesh 7 NGO Forum for Drinking Water, Lalmatia, Dhaka 1207, Bangladesh
* Author to whom correspondence should be addressed.
Received: 12 October 2012 / Revised: 27 November 2012 / Accepted: 29 November 2012 / Published: 7 December 2012
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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 >50μg/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.
Keywords: arsenic; drinking-water; hypertension; pulse-pressure; Bangladesh arsenic; drinking-water; hypertension; pulse-pressure; Bangladesh
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Islam, M.R.; Khan, I.; Attia, J.; Hassan, S.M.N.; McEvoy, M.; D'Este, C.; Azim, S.; Akhter, A.; Akter, S.; Shahidullah, S.M.; Milton, A.H. Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh. Int. J. Environ. Res. Public Health 2012, 9, 4522-4536.

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Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert