Article

Hypertension incidence after tap-water implementation: a 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan.

Division of Environmental Health & Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan.
Science of The Total Environment (Impact Factor: 3.16). 08/2011; 409(21):4528-35. DOI: 10.1016/j.scitotenv.2011.07.058
Source: PubMed

ABSTRACT Hypertension is the leading cause of cardiovascular disease worldwide. Long-term arsenic exposure has been linked to increased risk for hypertension; however, little is known whether a previous exposure has lingering effects on hypertension after the exposure being reduced significantly for decades. The study cohort was established in 1990 in an arseniasis-endemic area of 3 villages - Homei, Fuhsin, and Hsinming in Putai Township located on the southwestern coast of Taiwan, where residents were exposed to artesian well water (median level=700 to 930 μg/L) until early 1970s. The original cohort consisted of 490 non-hypertensive residents over 30-yrs-old and 352 of them were successfully followed up in 2002/03. Arsenic concentrations in the artesian well water consumed by residents during 1960s were used to indicate the previous exposure while urinary arsenic species measured in 2002/3 was used to represent current exposure. Hypertension incidences were 27.4, 65.6, and 69.1, per 1000 person-years for men aged 35-49, 50-64, and 65-74 years, respectively being higher than the corresponding rates of 25.1, 46.1, and 57.2 in a community-based longitudinal study. Cancer was the major cause of the total deaths (17/30=57%). Diastolic blood pressure was shown to increase with an increased cumulative arsenic ingestion from drinking water (β=0.27, p<0.001). The incidence was increased by 2.43-fold in subjects of As(V)≥2.67 μg/g creatinine as compared to those of As(V)<1.20 μg/g creatinine (the third vs. first tertile; p=0.047) after adjustment for conventional risk factors. This study suggests that three decades after cessation of drinking artesian well water, residents of the endemic area are still at increased risk for developing hypertension, particularly those who excrete high amounts of As(V).

0 Bookmarks
 · 
120 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1-8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46-8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41-19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.
    International Journal of Environmental Research and Public Health 01/2012; 9(12):4522-4536. · 2.00 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Several population studies relate exposure to high levels of arsenic with an increased incidence of ischemic heart disease and cardiovascular mortality. An association has been shown between exposure to high levels of arsenic and cardiovascular risk factors such as hypertension and diabetes mellitus, and vascular damage such as subclinical carotid atherosclerosis. The mechanisms underlying these phenomena are currently being studied and appear to indicate an alteration of vascular function. However, the effects of low levels of exposure to arsenic and their potential detrimental cardiovascular effect are less explored. The article provides an overview of the pathophysiologic mechanisms linking low-level arsenic exposure to the occurrence of cardiovascular disease and its complications, and some potential preventive strategies to implement.
    Environmental Science and Pollution Research 09/2013; · 2.76 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Arsenic in drinking water causes increased coronary artery disease (CAD) and death from CAD, but its association with stroke is not known. Prospective cohort study with arsenic exposure measured in well water at baseline. 61074 men and women aged 18 years or older on January 2003 were enrolled in 2003. The cohort was actively followed for an average of 7 years (421,754 person-years) through December 2010. Based on arsenic concentration the population was categorized in three groups and stroke mortality HR was compared to the referent. The risk of stroke mortality Hazard Ratio (HR) and 95% Confidence Interval was calculated in relation to arsenic exposure was estimated by Cox proportional hazard models with adjustment for potential confounders. A total of 1033 people died from stroke during the follow-up period, accounting for 23% of the total deaths. Multivariable adjusted HRs (95% confidence interval) for stroke for well water arsenic concentrations <10, 10-49, and >=50 mug/L were 1.0 (reference), 1.20 (0.92 to 1.57), and 1.35 (1.04 to 1.75) respectively (Ptrend=0.00058). For men, multivariable adjusted HRs (95%) for well water arsenic concentrations <10, 10-49, and >=50 mug/L were 1.0 (reference), 1.12 (0.78 to 1.60), and 1.07 (0.75 to 1.51) respectively (Ptrend=0.45) and for women 1.0 (reference),1.31 (0.87 to 1.98), and 1.72 (1.15 to 2.57) respectively (Ptrend=0.00004). The result suggests that arsenic exposure was associated with increased stroke mortality risk in this population, and was more significant in women compared to men.
    BMC Public Health 02/2014; 14(1):174. · 2.08 Impact Factor

Full-text

Download
34 Downloads
Available from
May 15, 2014