Association joint exposure to zinc, arsenic, cadmium, and lead with blood pressure

Abstract

Abstract Background Previous studies have demonstrated the adverse effect of single metal on blood pressure (BP) by oxidative stress, however, few studies investigated the joint effect of multi-metals co-exposure on BP. We aimed to estimate the association between multi-metal co-exposure and BP. Methods 2,764 residents living in heavy metal-contaminated areas of China for at least 5 years were recruited from August 2016 to July 2017 in this study. The average concentration of plasma zinc (Zn) and lead (Pb) and urine arsenic (As) and cadmium (Cd) were measured using an inductively coupled plasma mass spectrometer. The Ordinary least squares (OLS) linear regression and Bayesian kernel machine regression (BKMR) were utilized to assess the effect of the metals on systolic blood pressure (SBP) and diastolic blood pressure (DBP). All the metals were naturally log-transformed and As and Cd in urine were adjusted for urine creatinine levels. Results A total of 1,859 participants (58.40 ± 13.42 years old, 40.02% men) were included in the final analysis. The OLSlinear analyses showed that Zn and As were positively associated with SBP and DBP, while Cd was negatively associated with SBP and DBP. In the BKMR, we found a significantly positive joint effect of the metal mixture on BP when all the metal concentrations were above their medians. We also found the effects of the interaction between As and Zn on BP. Conclusions In conclusion, our study showed that multi-metal co-exposures caused an increase in BP in the population. Further prospective studies with larger sample sizes are necessary to validate this finding.