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Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh
Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
Department of Pharmacology, Dhaka Medical College, Dhaka 1000, Bangladesh
Department of Public Health, Atish Dipankar University of Science & Technology, Dhaka 1205, Bangladesh
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
Department of Obstetrics and Gynaecology, Tairunnessa Memorial Medical College, Targas, Kunia, Gazipur, Dhaka, Gazipur 1701, Bangladesh
Department of Paediatrics, Institute of Child and Mother Health (ICMH), Matuail, Demra, Dhaka 1362, Bangladesh
NGO Forum for Drinking Water, Lalmatia, Dhaka 1207, Bangladesh
* Author to whom correspondence should be addressed.
Received: 12 October 2012; in revised form: 27 November 2012 / Accepted: 29 November 2012 / Published: 7 December 2012
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 >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
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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.
Islam MR, Khan I, Attia J, Hassan SMN, McEvoy M, D'Este C, Azim S, Akhter A, Akter S, Shahidullah SM, Milton AH. Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh. International Journal of Environmental Research and Public Health. 2012; 9(12):4522-4536.
Islam, Mohammad R.; Khan, Ismail; Attia, John; Hassan, Sheikh M.N.; McEvoy, Mark; D'Este, Catherine; Azim, Syed; Akhter, Ayesha; Akter, Shahnaz; Shahidullah, Sheikh M.; Milton, Abul H. 2012. "Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh." Int. J. Environ. Res. Public Health 9, no. 12: 4522-4536.