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The association between environmental cadmium exposure, blood pressure, and hypertension: a systematic review and meta-analysis


We performed a systematic and meta-analysis study to find the association between cadmium (Cd) exposure and blood pressure (BP)/hypertension (HTN) in exposed general populations. We searched main databases for literature published between year 2000 and April 15, 2021. Quality assessment was performed with the Joanna Briggs Institute (JBI) critical appraisal tools. Heterogeneity between studies was determined by I-squared (I2) statistic. The random effects model was used to determine the association between blood and urine Cd levels with hypertension. The overall standard differences in mean for Cd level in hypertensive and control groups were 3.34, 1.79, and 8.09 based on samples from blood, urine, and hair, respectively. The overall standard differences in mean for Cd level in the low and high exposure groups were − 0.795 and − 1.036 based on blood and urinary samples, respectively. Our findings indicate a positive relationship between blood and hair Cd levels and hypertension. We also found that hair is the optimal biological sample to find the relationship between Cd exposure and hypertension for both genders. However, more studies are needed to confirm these findings.

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Blood pressure




The Joanna Briggs Institute


The Agency for Toxic Substances and Disease Registry


Systolic blood pressure


Diastolic blood pressure


Blood cadmium


Urine cadmium


Hair cadmium


Toenail cadmium


Preferred Reporting Items for Systematic Reviews and Meta-Analyses


Standard difference in means


Standard error


Confidence interval


  • Afridi H, Kazi T, Kazi N, Jamali M, Arain M, Baig, J.,... Shah, A. (2010) Evaluation of cadmium, lead, nickel and zinc status in biological samples of smokers and nonsmokers hypertensive patients. J Hum Hypertens 24(1):34–43

    CAS  Article  Google Scholar 

  • Afridi HI, Brabazon D, Kazi TG, Naher S, Nesterenko E (2011) Comparative metal distribution in scalp hair of Pakistani and Irish referents and hypertensive patients. Biol Trace Elem Res 143(3):1367–1382

    CAS  Article  Google Scholar 

  • Afridi HI, Kazi TG, Talpur FN, Brabazon D, Naher S (2013) Estimation of toxic elements in the samples of different cigarettes and their impact on human health of Irish hypertensive consumers. Clin Chim Acta 426:51–57

    CAS  Article  Google Scholar 

  • Afridi HI, Kazi TG, Talpur FN, Kazi A, Arain SS, Arain SA, … Ali J (2014) Interaction between essential elements selenium and zinc with cadmium and mercury in samples from hypertensive patients. Biol Trace Elem Res 160(2):185–196

  • Afridi H, Talpur F, Kazi T, Brabazon D (2015) Assessment of toxic elements in the samples of different cigarettes and their effect on the essential elemental status in the biological samples of Irish hypertensive consumers. J Hum Hypertens 29(5):309–315

    CAS  Article  Google Scholar 

  • Ahn J, Kim N-S, Lee B-K, Park J, Kim Y (2018) Association of blood pressure with blood lead and cadmium levels in Korean adolescents: analysis of data from the 2010–2016 Korean National Health and Nutrition Examination Survey. J Korean Med Sci 33(44).

  • Alexander J, Benford D, Cockburn A, Cravedi J-P, Dogliotti E, Di Domenico A, … Galli CL (2009) SCIENTIFIC OPINION Cadmium in food scientific opinion of the panel on contaminants in the food chain. EFSA J 980:1–139

  • Almenara CC, Oliveira TF, Padilha AS (2020) The role of antioxidants in the prevention of cadmium-induced endothelial dysfunction. Curr Pharm Des 26(30):3667–3675

    Article  CAS  Google Scholar 

  • Alotaibi A, Perry L, Gholizadeh L, Al-Ganmi A (2017) Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: an overview. J Epidemiol Glob Health 7(4):211–218

    Article  Google Scholar 

  • Al-Saleh I, Shinwari N, Mashhour A, Mohamed GE-D, Ghosh MA, Shammasi Z, Al-Nasser A (2006) Cadmium and mercury levels in Saudi women and its possible relationship with hypertension. Biol Trace Elem Res 112(1):13–29

    CAS  Article  Google Scholar 

  • Benson NU, Anake WU, Adedapo AE, Fred-Ahmadu OH, Ayejuyo OO (2017) Toxic metals in cigarettes and human health risk assessment associated with inhalation exposure. Environ Monit Assess 189(12):1–17

    CAS  Article  Google Scholar 

  • Biagioli M, Pifferi S, Ragghianti M, Bucci S, Rizzuto R, Pinton P (2008) Endoplasmic reticulum stress and alteration in calcium homeostasis are involved in cadmium-induced apoptosis. Cell Calcium 43(2):184–195

    CAS  Article  Google Scholar 

  • Boonprasert K, Ruengweerayut R, Satarug S, Na-Bangchang K (2011) Study on the association between environmental cadmium exposure, cytochrome P450-mediated 20-HETE, heme-oxygenase-1 polymorphism and hypertension in Thai population residing in a malaria endemic areas with cadmium pollution. Environ Toxicol Pharmacol 31(3):416–426

    CAS  Article  Google Scholar 

  • Boonprasert K, Vesey DA, Gobe GC, Ruenweerayut R, Johnson DW, Na-Bangchang K, Satarug S (2018) Is renal tubular cadmium toxicity clinically relevant? Clin Kidney J 11(5):681–687

    CAS  Article  Google Scholar 

  • Boskabady MH, Karimi GR, Samarghandian S, Farkhondeh T (2012) Tracheal responsiveness to methacholine and ovalbumin; and lung inflammation in guinea pigs exposed to inhaled lead after sensitization. Ecotoxicol Environ Saf 86:233–238.

  • Bromfield S, Muntner P (2013) High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep 15(3):134–136

    Article  Google Scholar 

  • Carretero OA, Oparil S (2000) Essential hypertension: part I: definition and etiology. Circulation 101(3):329–335

    CAS  Article  Google Scholar 

  • Castiello F, Olmedo P, Gil F, Molina M, Mundo A, Romero RR, … Freire C (2020) Association of urinary metal concentrations with blood pressure and serum hormones in Spanish male adolescents. Environ Res 182:108958

  • Chen X, Zhu G, Lei L, Jin T (2013) The association between blood pressure and blood cadmium in a Chinese population living in cadmium-polluted area. Environ Toxicol Pharmacol 36(2):595–599

    CAS  Article  Google Scholar 

  • Chen X, Wang Z, Zhu G, Liang Y, Jin T (2015) Benchmark dose estimation of cadmium reference level for hypertension in a Chinese population. Environ Toxicol Pharmacol 39(1):208–212

    CAS  Article  Google Scholar 

  • da Cunha Martins Jr A, Carneiro MFH, Grotto D, Adeyemi JA, Barbosa Jr F (2018) Arsenic, cadmium, and mercury-induced hypertension: mechanisms and epidemiological findings. J Toxicol Environ Health Part B 21(2):61–82

    Article  CAS  Google Scholar 

  • de Angelis C, Galdiero M, Pivonello C, Salzano C, Gianfrilli D, Piscitelli P, … Pivonello R (2017) The environment and male reproduction: the effect of cadmium exposure on reproductive function and its implication in fertility. Reprod Toxicol 73:105–127

  • De Toledo IP, Stefani FM, Porporatti AL, Mezzomo LA, Peres MA, Flores-Mir C, Canto GDL (2017) Prevalence of otologic signs and symptoms in adult patients with temporomandibular disorders: a systematic review and meta-analysis. Clin Oral Invest 21(2):597–605

    Article  Google Scholar 

  • Djordjevic VR, Wallace DR, Schweitzer A, Boricic N, Knezevic D, Matic S, … Bulat Z (2019) Environmental cadmium exposure and pancreatic cancer: evidence from case control, animal and in vitro studies. Environ Int 128:353–361

  • Farkhondeh T, Samarghandian S, Pourbagher-Shahri AM, Sedaghat M (2019) The impact of curcumin and its modified formulations on Alzheimer’s disease. J Cell Physiol 234(10):16953–16965.

    CAS  Article  Google Scholar 

  • Farkhondeh T, Folgado SL, Pourbagher-Shahri AM, Ashrafizadeh M, Samarghandian S (2020) The therapeutic effect of resveratrol: Focusing on the Nrf2 signaling pathway. Biomed Pharmacother 127:110234.

  • Franceschini N, Fry R, Balakrishnan P, Navas-Acien A, Oliver-Williams C, Howard AG, … Howard BV (2017) Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study. J Hum Hypertens 31(3):225–230

  • Gallagher CM, Meliker JR (2010) Blood and urine cadmium, blood pressure, and hypertension: a systematic review and meta-analysis. Environ Health Perspect 118(12):1676–1684

    CAS  Article  Google Scholar 

  • Gao Y, Zhu X, Shrubsole MJ, Fan L, Xia Z, Harris RC, … Dai Q (2018) The modifying effect of kidney function on the association of cadmium exposure with blood pressure and cardiovascular mortality: NHANES 1999–2010. Toxicol Appl Pharmacol 353:15–22

  • Garner RE, Levallois P (2017) Associations between cadmium levels in blood and urine, blood pressure and hypertension among Canadian adults. Environ Res 155:64–72

    CAS  Article  Google Scholar 

  • Gibson MA, Sarpong-Kumankomah S, Nehzati S, George GN, Gailer J (2017) Remarkable differences in the biochemical fate of Cd2+, Hg2+, CH3Hg+ and thimerosal in red blood cell lysate. Metallomics 9(8):1060–1072

    CAS  Article  Google Scholar 

  • Gökalp O, Özdem S, Dönmez S, Dogan M, Demirin H, Kara Y, … Delibas N (2009) Impairment of endothelium-dependent vasorelaxation in cadmium-hypertensive rats. Toxicol Ind Health 25(7):447–453

  • González-Muñoz MJ, Sánchez-Muniz FJ, Ródenas S, Sevillano MI, Marín MTL, Bastida S (2010) Differences in metal and metalloid content in the hair of normo-and hypertensive postmenopausal women. Hypertens Res 33(3):219–224

    Article  CAS  Google Scholar 

  • Hecht EM, Landy DC, Ahn S, Hlaing WM, Hennekens CH (2013) Hypothesis: cadmium explains, in part, why smoking increases the risk of cardiovascular disease. J Cardiovasc Pharmacol Ther 18(6):550–554

    CAS  Article  Google Scholar 

  • Hermann U, Kaulich T, Schweinsberg F (1989) Correlation of blood pressure and cadmium and lead content of the hair in nonsmoking males. Zentralbl Hyg Umweltmed 188(3–4):240–253

    CAS  Google Scholar 

  • Hu XF, Singh K, Chan HM (2018) Mercury exposure, blood pressure, and hypertension: a systematic review and dose–response meta-analysis. Environ Health Perspect 126(07):076002

    Article  Google Scholar 

  • Ikeda M, Moriguchi J, Sakuragi S, Ohashi F (2013) Association of past diseases with levels of cadmium and tubular dysfunction markers in urine of adult women in non-polluted areas in Japan. Int Arch Occup Environ Health 86(3):343–355

    CAS  Article  Google Scholar 

  • Järup L, Åkesson A (2009) Current status of cadmium as an environmental health problem. Toxicol Appl Pharmacol 238(3):201–208

    Article  CAS  Google Scholar 

  • Järup L, Berglund M, Elinde CG, Nordberg G, Vanter M (1998) Health effects of cadmium exposure–a review of the literature and a risk estimate. Scand J Work Environ health 1–51

  • Júnior JEGP, Moraes PZ, Rodriguez MD, Simões MR, Cibin F, Pinton S, … Miguel M (2020) Cadmium exposure activates NADPH oxidase, renin–angiotensin system and cyclooxygenase 2 pathways in arteries, inducing hypertension and vascular damage. Toxicol Lett 333:80–89

  • Kazantzis G (1987) Cadmium. In: Fishbein L, Furst A, Mehlman MA (eds) Genotoxic and carcinogenic metals: environmental and occupational occurrence and exposure Advances in Modern Environmental Toxicology, 11. Princeton Scientific Publishing Co., Princeton

    Google Scholar 

  • Kelishadi R, Askarieh A, Motlagh ME, Tajadini M, Heshmat R, Ardalan G, … Poursafa P (2013) Association of blood cadmium level with cardiometabolic risk factors and liver enzymes in a nationally representative sample of adolescents: the CASPIAN-III study. J Environ Public Health 2013:1–5

  • Kjeldsen SE (2018) Hypertension and cardiovascular risk: general aspects. Pharmacol Res 129:95–99

    Article  Google Scholar 

  • Kurihara I, Kobayashi E, Suwazono Y, Uetani M, Inaba T, Oishiz M, … Nogawa K (2004) Association between exposure to cadmium and blood pressure in Japanese peoples. Arch Environ Health: Int J 59(12):711–716

  • Lee M-S, Park SK, Hu H, Lee S (2011) Cadmium exposure and cardiovascular disease in the 2005 Korea National Health and Nutrition Examination Survey. Environ Res 111(1):171–176

    CAS  Article  Google Scholar 

  • Lee B-K, Ahn J, Kim N-S, Lee CB, Park J, Kim Y (2016) Association of blood pressure with exposure to lead and cadmium: analysis of data from the 2008–2013 Korean National Health and Nutrition Examination Survey. Biol Trace Elem Res 174(1):40–51

    CAS  Article  Google Scholar 

  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, … Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1–e34

  • Liu H, Xia W, Xu S, Zhang B, Huang Z, Zhang H, … Sun X (2018) Cadmium body burden and pregnancy-induced hypertension. Int J Hyg Environ Health 221(2):246–251

  • Madrigal JM, Ricardo AC, Persky V, Turyk M (2019) Associations between blood cadmium concentration and kidney function in the US population: impact of sex, diabetes and hypertension. Environ Res 169:180–188

    CAS  Article  Google Scholar 

  • Mahajan P, Kaushal J (2018) Role of phytoremediation in reducing cadmium toxicity in soil and water. J Toxicol 2018:1–16

    Article  CAS  Google Scholar 

  • Mahumud RA, Kamara JK, Renzaho AM (2020) The epidemiological burden of and overall distribution of chronic comorbidities in coronavirus disease-2019 among 202,005 infected patients: evidence from a systematic review and meta-analysis. Infection 1–21

  • Martins AC, Urbano MR, Lopes ACBA, Maria de Fatima HC, Buzzo ML, Docea AO, … Silbergeld EK (2020) Blood cadmium levels and sources of exposure in an adult urban population in southern Brazil. Environ Res 187:109618

  • Martins AC, Lopes ACBA, Urbano MR, Maria de Fatima HC, Silva AMR, Tinkov AA, … Paoliello MM (2021) An updated systematic review on the association between Cd exposure, blood pressure and hypertension. Ecotoxicol Environ Saf 208:111636

  • Mills KT, Stefanescu A, He J (2020) The global epidemiology of hypertension. Nat Rev Nephrol 16(4):223–237

    CAS  Article  Google Scholar 

  • Moon S-S (2014) Additive effect of heavy metals on metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009–2010. Endocrine 46(2):263–271

    CAS  Article  Google Scholar 

  • Mordukhovich I, Wright RO, Hu H, Amarasiriwardena C, Baccarelli A, Litonjua A, … Schwartz J (2012) Associations of toenail arsenic, cadmium, mercury, manganese, and lead with blood pressure in the normative aging study. Environ Health Perspect 120(1):98–104

  • Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C (2015) Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc 13(3):147–153

    Article  Google Scholar 

  • Myong J-P, Kim H-R, Jang T-W, Lee HE, Koo J-W (2014) Association between blood cadmium levels and 10-year coronary heart disease risk in the general Korean population: the Korean National Health and Nutrition Examination Survey 2008–2010. PloS One 9(11):e111909

    Article  CAS  Google Scholar 

  • Noor N, Zong G, Seely EW, Weisskopf M, James-Todd T (2018) Urinary cadmium concentrations and metabolic syndrome in US adults: the National Health and Nutrition Examination Survey 2001–2014. Environ Int 121:349–356

    CAS  Article  Google Scholar 

  • Oliver-Williams C, Howard AG, Navas-Acien A, Howard BV, Tellez-Plaza M, Franceschini N (2018) Cadmium body burden, hypertension, and changes in blood pressure over time: results from a prospective cohort study in American Indians. J Am Soc Hypertens 12(6):426-437. e429

    CAS  Article  Google Scholar 

  • Organization WH (1987) Air quality guidelines for Europe. WHO Regional Office for Europe, Copenhagen

    Google Scholar 

  • Park S, Choi N-K (2016) Associations of blood heavy metal levels with intraocular pressure. Ann Epidemiol 26(8):546–550541

    Article  Google Scholar 

  • Park SK, Zhao Z, Mukherjee B (2017) Construction of environmental risk score beyond standard linear models using machine learning methods: application to metal mixtures, oxidative stress and cardiovascular disease in NHANES. Environ Health 16(1):1–17

    CAS  Article  Google Scholar 

  • Pizent A, Jurasović J, Telišman S (2001) Blood pressure in relation to dietary calcium intake, alcohol consumption, blood lead, and blood cadmium in female nonsmokers. J Trace Elem Med Biol 15(2–3):123–130

    CAS  Article  Google Scholar 

  • Rahman MT, Haque N, Kasim NHA, De Ley M (2017) Origin, function, and fate of metallothionein in human blood. Rev Physiol Biochem Pharmacol 173:41–62

    Article  CAS  Google Scholar 

  • Samarghandian S, Azimi-Nezhad M, Mehrad-Majd H, Mirhafez SR (2015) Thymoquinone ameliorates acute renal failure in gentamicin-treated adult male rats. Pharmacology 96(3–4):112–117.

    CAS  Article  Google Scholar 

  • Samarghandian S, Samini F, Azimi-Nezhad M, Farkhondeh T (2017) Anti-oxidative effects of safranal on immobilization-induced oxidative damage in rat brain. Neurosci Lett 659:26–32.

  • Satarug S (2018) Dietary cadmium intake and its effects on kidneys. Toxics 6(1):15

    Article  CAS  Google Scholar 

  • Satarug S, Nishijo M, Ujjin P, Vanavanitkun Y, Moore MR (2005) Cadmium-induced nephropathy in the development of high blood pressure. Toxicol Lett 157(1):57–68

    CAS  Article  Google Scholar 

  • Scells H, Zuccon G, Koopman B, Deacon A, Azzopardi L, Geva S (2017) Integrating the framing of clinical questions via PICO into the retrieval of medical literature for systematic reviews. Paper presented at the Proceedings of the 2017 ACM on Conference on Information and Knowledge Management

  • Schutte R, Nawrot T, Richart T, Thijs L, Roels HA, Van Bortel LM, … Staessen JA (2008) Arterial structure and function and environmental exposure to cadmium. Occup Environ Med 65(6):412–419

  • Shi P, Jing H, Xi S (2019) Urinary metal/metalloid levels in relation to hypertension among occupationally exposed workers. Chemosphere 234:640–647

    CAS  Article  Google Scholar 

  • Shiue I, Hristova K (2014) Higher urinary heavy metal, phthalate and arsenic concentrations accounted for 3–19% of the population attributable risk for high blood pressure: US NHANES, 2009–2012. Hypertens Res 37(12):1075–1081

    CAS  Article  Google Scholar 

  • Sirivarasai J, Kaojarern S, Wananukul W, Deechakwan W, Srisomerarn P (2004) Non-occupational lead and cadmium exposure and blood pressure in Thai men. Asia Pac J Public Health 16(2):133–137

    CAS  Article  Google Scholar 

  • Skröder H, Hawkesworth S, Kippler M, El Arifeen S, Wagatsuma Y, Moore SE, Vahter M (2015) Kidney function and blood pressure in preschool-aged children exposed to cadmium and arsenic-potential alleviation by selenium. Environ Res 140:205–213

    Article  CAS  Google Scholar 

  • Slotnick MJ, Nriagu JO (2006) Validity of human nails as a biomarker of arsenic and selenium exposure: a review. Environ Res 102(1):125–139

    CAS  Article  Google Scholar 

  • Staessen JA, Kuznetsova T, Roels HA, Emelianov D, Fagard R (2000) Exposure to cadmium and conventional and ambulatory blood pressures in a prospective population study. Am J Hypertens 13(2):146–156

    CAS  Article  Google Scholar 

  • Swaddiwudhipong W, Limpatanachote P, Nishijo M, Honda R, Mahasakpan P, Krintratun S (2010) Cadmium-exposed population in Mae Sot district, Tak province: 3. Associations between urinary cadmium and renal dysfunction, hypertension, diabetes, and urinary stones. J Med Assoc Thailand= Chotmaihet thangphaet 93(2):231–238

    Google Scholar 

  • Swaddiwudhipong W, Mahasakpan P, Limpatanachote P, Krintratun S (2010b) Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: a population study. Environ Res 110(6):612–616

    CAS  Article  Google Scholar 

  • Swaddiwudhipong W, Limpatanachote P, Mahasakpan P, Krintratun S, Punta B, Funkhiew T (2012) Progress in cadmium-related health effects in persons with high environmental exposure in northwestern Thailand: a five-year follow-up. Environ Res 112:194–198

    CAS  Article  Google Scholar 

  • Swaddiwudhipong W, Mahasakpan P, Jeekeeree W, Funkhiew T, Sanjum R, Apiwatpaiboon T, Phopueng I (2015a) Renal and blood pressure effects from environmental cadmium exposure in Thai children. Environ Res 136:82–87

    CAS  Article  Google Scholar 

  • Swaddiwudhipong W, Nguntra P, Kaewnate Y, Mahasakpan P, Limpatanachote P, Aunjai T, … Phopueng I (2015b) Human health effects from cadmium exposure: comparison between persons living in cadmium-contaminated and non-contaminated areas in northwestern Thailand. Southeast Asian J Trop Med Public Health 46(1):133

  • Tangvarasittichai S, Niyomtam S, Meemark S, Pingmuangkaew P, Nunthawarasilp P (2015) Elevated cadmium exposure associated with hypertension, diabetes and chronic kidney disease, in the population of cadmium-contaminated area. Int J Toxicol Pharmacol Res 7(1):50–56

    Google Scholar 

  • Telišman S, Jurasović J, Pizent A, Cvitković P (2001) Blood pressure in relation to biomarkers of lead, cadmium, copper, zinc, and selenium in men without occupational exposure to metals. Environ Res 87(2):57–68

    Article  CAS  Google Scholar 

  • Tellez-Plaza M, Navas-Acien A, Crainiceanu CM, Guallar E (2008) Cadmium exposure and hypertension in the 1999–2004 National Health and Nutrition Examination Survey (NHANES). Environ Health Perspect 116(1):51–56

    CAS  Article  Google Scholar 

  • Vallée A, Gabet A, Grave C, Blacher J, Olié V (2020) Associations between urinary cadmium levels, blood pressure, and hypertension: the ESTEBAN survey. Environ Sci Pollut Res 1–9

  • Van Larebeke N, Sioen I, Den Hond E, Nelen V, Van de Mieroop E, Nawrot T, … Baeyens W (2015) Internal exposure to organochlorine pollutants and cadmium and self-reported health status: a prospective study. Int J Hyg Environ Health 218(2):232–245

  • Wang Q, Wei S (2018) Cadmium affects blood pressure and negatively interacts with obesity: findings from NHANES 1999–2014. Sci Total Environ 643:270–276.

    CAS  Article  Google Scholar 

  • Whelton P, Carey R, Aronow W, Casey Jr D, Collins K, Dennison Himmelfarb C, … MacLaughlin E (2017) ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017

  • Wu H, Liao Q, Chillrud SN, Yang Q, Huang L, Bi J, Yan B (2016) Environmental exposure to cadmium: health risk assessment and its associations with hypertension and impaired kidney function. Sci Rep 6(1):1–9

    Article  CAS  Google Scholar 

  • Wu W, Jiang S, Zhao Q, Zhang K, Wei X, Zhou T, … Lu Q (2018a) Associations of environmental exposure to metals with the risk of hypertension in China. Sci Total Environ 622–623:184–191.

  • Wu W, Zhang K, Jiang S, Liu D, Zhou H, Zhong R, … Lu Q (2018b) Association of co-exposure to heavy metals with renal function in a hypertensive population. Environ Int 112:198–206.

  • Wu W, Liu D, Jiang S, Zhang K, Zhou H, Lu Q (2019) Polymorphisms in gene MMP-2 modify the association of cadmium exposure with hypertension risk. Environ Int 124:441–447.

    CAS  Article  Google Scholar 

  • Yao B, Lu X, Xu L, Wang Y, Qu H, Zhou H (2020) Relationship between low-level lead, cadmium and mercury exposures and blood pressure in children and adolescents aged 8–17 years: an exposure-response analysis of NHANES 2007–2016. Sci Total Environ 726:138446.

    CAS  Article  Google Scholar 

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TF and SS involved in the conceptualization, validation of resources, and data extraction. HA, MAZ, TF, AF, AN (Abolfazl Naimabad), and SS performed the writing of the manuscript, SS, AN (Ali Naghizadeh), and MA reviewed and edited the manuscript. All of the authors read and approved the final manuscript.

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Correspondence to Saeed Samarghandian.

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Aramjoo, H., Arab-Zozani, M., Feyzi, A. et al. The association between environmental cadmium exposure, blood pressure, and hypertension: a systematic review and meta-analysis. Environ Sci Pollut Res 29, 35682–35706 (2022).

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  • Blood pressure
  • Cadmium
  • Environmental exposure
  • High blood pressure
  • Hypertension
  • Meta-analysis