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Arsenic Exposure and Hypertension: A Systematic Review
Open accessAbstract
Background: Environmental exposure to arsenic has been linked to hypertension in persons living in arsenic-endemic areas. Objective: We summarized published epidemiologic studies concerning arsenic exposure and hypertension or blood pressure (BP) measurements to evaluate the potential relationship. Data sources and extraction: We searched PubMed, Embase, and TOXLINE and applied predetermined exclusion criteria. We identified 11 cross-sectional studies from which we abstracted or derived measures of association and calculated pooled odds ratios (ORs) using inverse-variance weighted random-effects models. Data synthesis: The pooled OR for hypertension comparing the highest and lowest arsenic exposure categories was 1.27 [95% confidence interval (CI): 1.09, 1.47; p-value for heterogeneity = 0.001; I2 = 70.2%]. In populations with moderate to high arsenic concentrations in drinking water, the pooled OR was 1.15 (95% CI: 0.96, 1.37; p-value for heterogeneity = 0.002; I2 = 76.6%) and 2.57 (95% CI: 1.56, 4.24; p-value for heterogeneity = 0.13; I2 = 46.6%) before and after excluding an influential study, respectively. The corresponding pooled OR in populations with low arsenic concentrations in drinking water was 1.56 (95% CI: 1.21, 2.01; p-value for heterogeneity = 0.27; I2 = 24.6%). A dose–response assessment including six studies with available data showed an increasing trend in the odds of hypertension with increasing arsenic exposure. Few studies have evaluated changes in systolic and diastolic BP (SBP and DBP, respectively) measurements by arsenic exposure levels, and those studies reported inconclusive findings. Conclusion: In this systematic review we identified an association between arsenic and the prevalence of hypertension. Interpreting a causal effect of environmental arsenic on hypertension is limited by the small number of studies, the presence of influential studies, and the absence of prospective evidence. Additional evidence is needed to evaluate the dose–response relationship between environmental arsenic exposure and hypertension.
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“Researchers have pointed out that trivalent arsenicals (AsIII, MMAIII, and DMAIII) can induce diabetes via distortion of glucose metabolism based on intact pancreatic islets from mice [75, 76].”
From Arsenic Contamination of Groundwater: A Review of Sources, Prevalence, Health Risks, and Strategies for Mitigation (2014) · cites this paper as [76]
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Metadata
- Authors
- Abhyankar, L. N., Jones, M. R., Guallar, E., & Navas-Acien, A.
- Affiliations
- Johns Hopkins University (US)
- Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, and
- ORCID
- Jones, Miranda R.
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2011-12-02
- Volume
- 120
- Issue
- 4
- Pages
- 494-500
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC3339454
- OpenAlex
- W1984271811
- Cited by
- 281
- References
- 53
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 22 · 2023: 5 · 2022: 25 · 2021: 31 · 2020: 28 · 2019: 17 · 2018: 18 · 2017: 22 · 2016: 22 · 2015: 24 · 2014: 25 · 2013: 17 · 2012: 2
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 2219 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl090863-04)
- National Heart, Lung, and Blood Institute (R01-HL-090863)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Arsenic contamination and mitigation
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Heavy Metal Exposure and Toxicity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- arsenic exposure, hypertension, blood pressure, drinking water arsenic, dose-response relationship, arsenic endemic areas, environmental arsenic, systolic blood pressure, diastolic blood pressure
- MeSH terms
- Arsenic, Blood Pressure, Dose-Response Relationship, Drug, Environmental Exposure, Humans, Hypertension, Prevalence, Drinking Water
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