Abstract
High-level arsenic exposure is widely considered to be associated with hypertension. However, the relationship between arsenic metabolism and hypertension under high-level exposure remains controversial. In addition, the evidence at low-to-moderate levels remains unelucidated. This research aims to evaluate the relationship between arsenic metabolism and the risk of hypertension in a Chinese population under different levels of arsenic exposure. A cross-sectional survey of 1932 participants exposed to different arsenic concentrations through contaminated drinking water was conducted in epidemic areas in southwest and northwest China. Based on the World Health Organization’s drinking-water standards, the study population was stratified into two subgroups: high-exposure (water As concentration (wAs) ≥ 50 μg/L) and low-to-moderate (10 ≤ wAs < 50 μg/L) exposure. Arsenic metabolism capacity was evaluated by the relative fractions of inorganic arsenic (iAs), monomethylarsenate (MMA) and dimethylarsenate (DMA) in urine (denoted by iAs%, MMA%, DMA%, primary methylation index and the secondary methylation index). The relationship between arsenic metabolism and hypertension was evaluated by the leave-one-out approach, which modeled the dynamics of arsenic metabolism. There were significant differences and associations between individual factors and the distribution of urinary arsenic metabolites at different arsenic exposure levels. Increased MMA% was associated with higher risk of hypertension when either iAs% or DMA% decreased at different arsenic exposures. iAs% was associated with lower risk of hypertension only when MMA% decreased in both subgroups. In addition, higher DMA% was both associated with lower hypertension prevalence when either iAs% or MMA% decreased only at low-to-moderate arsenic exposure. In summary, arsenic metabolism, particularly higher MMA%, was associated with increased risk of hypertension in the Chinese arsenic-exposed population with both high and low-to-moderate levels, which provides additional evidence for the assessment of arsenic-induced hypertension incident.
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Data Availability
The data supporting the results of this study are available from the corresponding authors upon reasonable request.
Abbreviations
- As:
-
Arsenic
- wAs:
-
Water arsenic
- iAs:
-
Inorganic arsenic
- MMA:
-
Monomethylarsonic acid
- DMA:
-
Dimethylarsinic acid
- PMI:
-
Primary methylation index
- SMI:
-
Secondary methylation index
- tAs:
-
Total arsenic in urine
- UCre:
-
Urinary creatinine
- SBP:
-
Systolic blood pressure
- DBP:
-
Diastolic blood pressure
- 95% CIs:
-
95% Confidence intervals
- WHO:
-
World Health Organization
- ISH:
-
International Society of Hypertension
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Acknowledgements
This work was supported by grants from National Nature Science Foundation of China (Grant Number 81372933). We gratefully acknowledged the assistance and cooperation of the faculty and staff of the Centers for Endemic Disease Control and Prevention in Shanxi, Inner Mongolia, and Dali, Yunnan, and thank all those who participated in our study. We would like to thank Darren Jen-Sung Lu and Juehan (Hanna) Ye from the University of Pennsylvania for editing this manuscript.
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Dong, Y., Zhou, M., Zhang, M. et al. The Association Between Arsenic Metabolism and Hypertension Among Population with Varying Arsenic Exposure Levels in China. Expo Health 14, 411–430 (2022). https://doi.org/10.1007/s12403-022-00462-8
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DOI: https://doi.org/10.1007/s12403-022-00462-8