Biological Trace Element Research

, Volume 185, Issue 2, pp 282–288 | Cite as

Association of Hypertension, Body Mass Index, and Waist Circumference with Fluoride Intake; Water Drinking in Residents of Fluoride Endemic Areas, Iran

  • Mahmood Yousefi
  • Mehdi Yaseri
  • Ramin Nabizadeh
  • Elham Hooshmand
  • Mohsen Jalilzadeh
  • Amir Hossein Mahvi
  • Ali Akbar Mohammadi


Hypertension is becoming a global epidemic for both rural and urban populations; it is a major public health challenge in Iran. Fluoride can be a risk factor for hypertension. Cross-sectional analysis was conducted in two study areas to assess the relation of fluoride with blood pressure prevalence, BMI, waist circumference, and waist-to-hip ratio (WHR) among different age groups in both sexes. The mean value of fluoride concentration in the drinking water from the four study villages varied from 0.68 to 10.30 mg/L. The overall prevalence of HTN and prehypertension in all subjects was 40.7%. The prevalence of isolated systolic hypertension, isolated diastolic hypertension, systolic-diastolic hypertension, and prehypertension in the total sample population was 1.15, 0.28, 9.53, and 29.76%, respectively. The odd ratio of hypertension in residents who drank water with high fluoride levels was higher than that in residents who drank water with lower level of fluoride (OR 2.3, 1.03–5.14). Logistic regression results showed that age (P < 0.001), sex (P = 0.018), BMI (P = 0.015), and the fluoride level in drinking water (P = 0.041) had a significant relationship with increased blood pressure. There were no statistically significant correlations between fluoride and BMI, hip circumference, and waist to hip ratio (WHR). The findings of this study are important for health care personnel and policymakers.


Drinking water Fluoride endemic Hypertension BMI Poldasht Iran 



Isolated systolic hypertension


Diastolic blood pressure


Isolated diastolic hypertension


waist-to-hip ratio


Systolic-diastolic hypertension


Mean Arterial Pressure




Total dissolved solids




Total hardness




Body mass index


Systolic blood pressure


World Health Organization



The authors want to thank the authorities of Neyshabur University of Medical Sciences and Poldasht Health Centre Department for their comprehensive support for this study.

Compliance with Ethical Standards

Competing Interests

The authors declare that they have no competing interests.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Mahmood Yousefi
    • 1
    • 2
  • Mehdi Yaseri
    • 3
  • Ramin Nabizadeh
    • 2
    • 4
  • Elham Hooshmand
    • 5
  • Mohsen Jalilzadeh
    • 6
  • Amir Hossein Mahvi
    • 2
    • 7
  • Ali Akbar Mohammadi
    • 8
  1. 1.Students Research CommitteeNeyshabur University of Medical SciencesNeyshaburIran
  2. 2.Department of Environmental Health Engineering, School of Public HealthTehran University of Medical ScienceTehranIran
  3. 3.Department of Epidemiology and Biostatistics, School of Public HealthTehran University of MedicalTehranIran
  4. 4.Center for Air Pollution Research, Institute for Environmental Research (IER)Tehran University of Medical SciencesTehranIran
  5. 5.Neyshabur University of Medical ScienceNeyshaburIran
  6. 6.Department of EpidemiologyUrmia University of Medical SciencesUrmiaIran
  7. 7.Center for Solid Waste Research, Institute for Environmental ResearchTehran University of Medical SciencesTehranIran
  8. 8.Department of Environmental Health EngineeringNeyshabur University of Medical SciencesNeyshaburIran

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