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Published online 2011 Dec 2. doi: 10.1289/ehp.1103988
Table 1
Epidemiological studies of arsenic exposure and blood pressure end points.
Reference | n | Percent men | Arsenic | Definition of hypertension | No. of cases | Adjustment variables | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Country | Population | Age | Marker | Mean ± SD | Range | SBP/DBP determinations | ||||||||
Moderate to high arsenic levels in drinking water (average ≥ 50 μg/L) or occupationally exposed populations | ||||||||||||||
Chen CJ et al. 1995 | Southwest Taiwan | General | 898 | 42.5 | ≥ 30 years | CAE in groundwater | NR | 0 to > 18.5 mg/L-years | Mean of three SBP and DBP measures after 20 min of rest with mercury sphygmomanometer | SBP ≥ 160 mmHg, DBP ≥ 95 mmHg, HT medication | 168 | Age, sex, BMI, diabetes, proteinuria, fasting serum triglycerides | ||
Jensen and Hansen 1998 | Denmark | Occupational | 59 | NR | Mean age, 37 years | Occupational exposure (confirmed in urine) | Exposed,a 14.8 μg /g creatinine Unexposed, 7.9 μg /g | Exposed,a 7.6–195.6 Unexposed, 3.9–29.1 | Mean of three SBP and DBP measures after 10 min of rest with digital equipment | NA | NA | None | ||
Rahman et al. 1999 | Central and eastern Bangladesh | General | 1,595 | 59.7 | 30–85 years | CAE in groundwater | NR | 0 to > 10 mg/L-years | Lowest BP of three measures used; two additional measurements taken for individuals w/HT | SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg | 207 | Age, sex, BMI | ||
Chen Y et al. 2007 | Araihazar, Bangladesh | General | 11,458 | 42.8 | ≥ 18 years | TWA concentration in groundwater | NR | 0.1–864.0 μg/L | SBP and DBP measured by trained clinicians with automatic sphygmomanometer after 2–3 min of rest Two or more measures taken for persons with SBP/DBP ≥ 140/90 mmHg at first measure Lowest BP used | SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg | 1,360 | Age, sex, BMI, smoking, education, daily water consumption | ||
Guo et al. 2007 | Inner Mongolia, China | General | 869 | NA | Childbearing age | High vs. low arsenic in water | NR | 50–1,860 μg/L | NA | NR | 56 | None | ||
Kwok et al. 2007 | Inner Mongolia, China | General (postpartum) | 3,260 | 0.0 | 17–45 years | Individual groundwater concentration | NR | < LODa to > 100 μg/L | SBP and DBP measured after 5 min of rest at 6 weeks postpartum using appropriately sized cuff | NA | NA | Age, body weight | ||
Yildiz et al. 2008 | Dulkadir and Alikoy, Turkey | General | 80 | 100 | Mean age, 35 years | High vs. low arsenic in water | 659 ± 323 μg/L | 422–1,066 μg/L | NR | NR | 14 | None | ||
Dastgiri et al. 2010 | Ghopuz and Mayan, Iran | General | 208 | 42.7 | ≥ 6 years; mean age, 33 years | High vs. low arsenic in water | 1.031 mg/L | NR | SBP and DBP measured once after 10 min rest using portable sphygmomanometer | NA | NA | None | ||
Low arsenic levels in drinking water (average < 50 μg/L) | ||||||||||||||
Zierold et al. 2004 | Wisconsin, USA | General | 1,185 | NA | ≥ 35 years | Individual groundwater concentration | Median, 2 μg/L | 0–2,389 μg/L | NA | Self-reported | NR | Age, sex, BMI, smoking | ||
Wang SL et al. 2007 | Central Taiwan | General | 432 | 44.2 | 35–64 years | Hair, total arsenic | 0.071 μg/g creatinine | NR | Mean of two SBP and DBP measures using mercury sphygmomanometer with appropriately sized cuff Two measures carried out 30 min apart; if difference > 5%, BP measured third time and two closest used | SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg, HT medication | NR | None | ||
Jones et al. 2011 | USA | General | 4,167 | 49.0 | Mean age, 47.7 years | Urine arsenic (μg/L) | Median, 8.3 μg/L | < 0.6 to > 17.1 μg/L | Mean of three or four SBP and DBP measures by certified examiners using appropriately sized cuff after 5 min rest | SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg, HT medication | 1,761 | Age, sex, race, ethnicity, urine creatinine, education, BMI, serum cotinine, arsenobetaine | ||
Abbreviations: BP, blood pressure; CAE, cumulative arsenic exposure, assessed by measuring the arsenic concentration in groundwater at the village level multiplied by the drinking duration at the individual level (Chen CJ et al. 1995); HT, hypertension; LOD, limit of detection; NA, not available; NR, not reported; TWA, time-weighted arsenic concentration, calculated as ΣCiTi/ΣTi, where “Ci and Ti denote the well arsenic concentration and drinking duration for the ith well” (Chen Y et al. 2007). aNot used in the statistical analysis; reported exclusively to confirm arsenic differences in exposed and unexposed participants. |