Serum Copper Concentrations, Effect Modifiers and Blood Pressure: Insights from NHANES 2011–2014
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurement of Serum Copper
2.3. Measurement of Blood Pressure Levels and Diagnosis of Hypertension
2.4. Antihypertensive Medications
2.5. Covariates
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Association of Serum Copper with Untreated Hypertension
3.3. Association of Serum Copper with Blood Levels for Non-Hypertension
3.4. Association of Serum Copper with Treated Hypertension
3.5. Subgroup and Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Quartiles of Serum Copper, μmol/L | |||||||
---|---|---|---|---|---|---|---|
Variables | Total | Q1 (<15.59) | Q2 (15.59–17.96) | Q3 (17.96–21.02) | Q4 (>21.02) | P | P for Trend |
n = 3376 | n = 846 | n = 850 | n = 838 | n = 842 | |||
Age, year | 48.00 (34.00–63.00) | 42.00 (30.00–59.00) | 49.00 (33.00–64.00) | 53.00 (39.00–64.00) | 50.00 (34.00–63.00) | <0.001 | <0.001 |
Sex, % (n) | <0.001 | <0.001 | |||||
Male | 49.61% (1675) | 77.66% (657) | 61.29% (521) | 41.77% (350) | 17.46% (147) | ||
Female | 50.39% (1701) | 22.34% (189) | 38.71% (329) | 58.23% (488) | 82.54% (695) | ||
Education level, % (n) | <0.001 | <0.001 | |||||
Below high school | 22.38% (755) | 17.73% (150) | 22.03% (187) | 25.54% (214) | 24.26% (204) | ||
High school | 21.19% (715) | 19.39% (164) | 23.09% (196) | 21.12% (177) | 21.17% (178) | ||
Above high school | 56.43% (1904) | 62.88% (532) | 54.89% (466) | 53.34% (447) | 54.58% (459) | ||
Smoking, % (n) | <0.001 | 0.075 | |||||
Never | 56.92% (1921) | 61.23% (518) | 54.24% (461) | 51.49% (431) | 60.69% (511) | ||
Former | 23.29% (786) | 22.58% (191) | 26.12% (222) | 24.85% (208) | 19.60% (165) | ||
Current | 19.79% (668) | 16.19% (137) | 19.65% (167) | 23.66% (198) | 19.71% (166) | ||
Drinking, % (n) | 0.034 | 0.001 | |||||
Never | 15.24% (466) | 13.73% (106) | 13.05% (100) | 15.80% (121) | 18.44% (139) | ||
Former | 16.38% (501) | 14.64% (113) | 17.49% (134) | 16.84% (129) | 16.58% (125) | ||
Current | 68.38% (2091) | 71.63% (553) | 69.45% (532) | 67.36% (516) | 64.99% (490) | ||
BMI, kg/m2 | 28.97 ± 7.08 | 26.52 ± 5.07 | 28.16 ± 6.01 | 29.70 ± 7.19 | 31.50 ± 8.59 | <0.001 | <0.001 |
eGFR, mL/min/1.73 m2 | 94.14 ± 23.45 | 95.26 ± 22.86 | 94.19 ± 23.28 | 91.91 ± 23.02 | 95.18 ± 24.50 | 0.011 | 0.459 |
HDL-C, mmol/L | 1.36 ± 0.40 | 1.30 ± 0.36 | 1.35 ± 0.41 | 1.38 ± 0.41 | 1.43 ± 0.41 | <0.001 | <0.001 |
Diabetes, % (n) | 18.95% (628) | 15.49% (129) | 16.91% (141) | 20.76% (170) | 22.71% (188) | <0.001 | <0.001 |
CAD, % (n) | 6.48% (218) | 5.92% (50) | 7.21% (61) | 7.17% (60) | 5.62% (47) | 0.41 | 0.801 |
SBP, mmHg | 123.11 ± 17.94 | 121.43 ± 16.28 | 123.03 ± 18.04 | 124.58 ± 18.74 | 123.45 ± 18.51 | 0.005 | 0.092 |
DBP, mmHg | 70.17 ± 12.74 | 70.95 ± 11.26 | 70.36 ± 12.75 | 69.41 ± 13.64 | 69.93 ± 13.20 | 0.097 | 0.275 |
Hypertension, % (n) | 29.50% (996) | 21.63% (183) | 28.35% (241) | 33.89% (284) | 34.20% (288) | <0.001 | <0.001 |
Treated Hypertension, % (n) | 20.43% (611) | 12.76% (97) | 19.55% (148) | 23.59% (171) | 26.03% (195) | <0.001 | <0.001 |
Untreated Hypertension, % (n) | 13.92% (385) | 11.48% (86) | 13.25% (93) | 16.94% (113) | 14.37% (93) | 0.027 | 0.030 |
Serum Copper (μmol/L) | Cases | Non-Cases | Crude Model | Adjusted Model |
---|---|---|---|---|
OR (95% CI) | ||||
Q1 (<15.59) | 86 | 663 | 1.00 (Ref) | |
Q2 (15.59–17.96) | 93 | 609 | 1.18 (0.86–1.61) | 1.02 (0.74–1.42) |
Q3 (17.96–21.02) | 113 | 554 | 1.57 (1.16–2.13) | 1.23 (0.88–1.72) |
Q4 (>21.02) | 93 | 554 | 1.29 (0.95–1.77) | 1.08 (0.74–1.58) |
P-trend | 0.030 | 0.471 | ||
1SD increase | 385 | 2380 | 1.07 (0.96–1.18) | 1.04 (0.91–1.18) |
Serum Copper (μmol/L) | Crude Model | Adjusted Model |
---|---|---|
β (95% CI) | ||
SBP | ||
Q1 (<15.59) | 1.00 (Ref) | |
Q2 (15.59–17.96) | −0.54 (−1.78–0.70) | −0.92 (−2.07–0.23) |
Q3 (17.96–21.02) | 0.38 (−0.89–1.65) | −0.05 (−1.30–1.20) |
Q4 (>21.02) | −1.29 (−2.56–(−0.02)) | −0.48 (−1.83–0.88) |
P-trend | 0.161 | 0.775 |
1SD increase | −0.43 (−0.87–0.02) | 0.06 (−0.40–0.53) |
DBP | ||
Q1 (<15.59) | 1.00 (Ref) | |
Q2 (15.59–17.96) | −1.44 (−2.63–(−0.25)) | −1.42 (−2.62–(−0.22)) |
Q3 (17.96–21.02) | −0.91 (−2.13–0.31) | −0.95 (−2.26–0.35) |
Q4 (>21.02) | −1.23 (−2.45–(−0.01)) | −1.28 (−2.70–0.13) |
P-trend | 0.092 | 0.129 |
1SD increase | −0.20 (−0.63–0.23) | −0.17 (−0.66–0.32) |
Outcomes | Categorical Models | Continuous Models | |||||||
---|---|---|---|---|---|---|---|---|---|
Cases | Non-Cases | Q1 | Q2 | Q3 | Q4 | P for Trend | 1SD Increase | p-Value | |
Treated Hypertension | 611 | 2380 | 1.00 (Ref) | 1.36 (0.99–1.89) | 1.49 (1.07–2.07) | 1.83 (1.29–2.60) | 0.001 | 1.22 (1.09–1.38) | 0.001 |
Treated Hypertension a | 611 | 2380 | 1.00 (Ref) | 1.36 (0.88–2.10) | 1.35 (0.87–2.09) | 1.56 (0.98–2.47) | 0.088 | 1.16 (0.97–1.37) | 0.096 |
Antihypertensive use | |||||||||
ACE-I | 85 | 2380 | 1.00 (Ref) | 0.85 (0.42–1.74) | 1.54 (0.79–2.99) | 1.55 (0.75–3.20) | 0.109 | 1.21 (0.93–1.57) | 0.151 |
ARB | 38 | 2380 | 1.00 (Ref) | 1.26 (0.49–3.26) | 0.88 (0.32–2.42) | 0.47 (0.14–1.52) | 0.157 | 0.71 (0.45–1.11) | 0.136 |
BB | 43 | 2380 | 1.00 (Ref) | 5.36 (1.52–18.86) | 3.05 (0.78–11.89) | 5.00 (1.30–19.28) | 0.094 | 1.41 (0.99–2.00) | 0.053 |
CCB | 34 | 2380 | 1.00 (Ref) | 1.54 (0.88–2.68) | 1.84 (1.05–3.21) | 1.71 (0.94–3.13) | 0.082 | 1.12 (0.91–1.37) | 0.275 |
Thiazides | 37 | 2380 | 1.00 (Ref) | 5.54 (0.67–46.06) | 5.59 (0.67–46.89) | 15.74 (1.92–129.02) | 0.001 | 1.72 (1.26–2.36) | 0.001 |
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Xu, R.-N.; Zhang, Y.; Xu, X.; Li, X.; He, L.; Feng, Q.; Yang, Y.-H.; He, Y.; Ma, X.; He, Y.-M. Serum Copper Concentrations, Effect Modifiers and Blood Pressure: Insights from NHANES 2011–2014. J. Cardiovasc. Dev. Dis. 2023, 10, 432. https://doi.org/10.3390/jcdd10100432
Xu R-N, Zhang Y, Xu X, Li X, He L, Feng Q, Yang Y-H, He Y, Ma X, He Y-M. Serum Copper Concentrations, Effect Modifiers and Blood Pressure: Insights from NHANES 2011–2014. Journal of Cardiovascular Development and Disease. 2023; 10(10):432. https://doi.org/10.3390/jcdd10100432
Chicago/Turabian StyleXu, Ruo-Nan, Yue Zhang, Xin Xu, Xu Li, Lan He, Qiang Feng, Yong-Hai Yang, Yang He, Xiao Ma, and Yong-Ming He. 2023. "Serum Copper Concentrations, Effect Modifiers and Blood Pressure: Insights from NHANES 2011–2014" Journal of Cardiovascular Development and Disease 10, no. 10: 432. https://doi.org/10.3390/jcdd10100432