Mercury exposure, blood pressure, and hypertension: A systematic review and dose–response meta-analysis
Open accessAbstract
Background: Body burden of mercury has been linked to hypertension in populations exposed to high mercury levels. Objectives: We summarized, extracted, and pooled the results of published studies that investigated mercury biomarkers and hypertension or blood pressure (BP) measurements to examine this potential relationship. Methods: We searched PubMed, Embase, and TOXLINE and selected studies according to a priori defined inclusion criteria. Study quality was assessed by the Newcastle-Ottawa scale for cohort and case–control studies and the Quality Assessment Tool for cross-sectional studies. Study estimates were pooled using inverse-variance weighted random-effects models. Dose–response meta-analysis was performed with studies reporting hypertension and systolic BP for at least three mercury categories. Results: A total of 29 studies were included in the meta-analysis. The pooled odds ratio (OR) for hypertension, comparing the highest and lowest mercury exposure categories, was 1.35 [95% confidence interval (CI): 0.99, 1.83] for populations with hair mercury ≥2μg/g in comparison with the OR of 1.12 (95% CI: 0.82, 1.52) for populations with hair mercury <2μg/g. Positive associations were also observed for highest versus lowest mercury exposure categories on systolic and diastolic BP. Heterogeneity was observed for mercury species and exposure groups across different studies. Associations estimated using different mercury biomarkers generally agree with each other in the same study. A nonlinear dose–response relationship with an inflection point at 3μg/g was identified, for both hypertension and systolic BP. Conclusions: A significant positive association between mercury and hypertension and between mercury and BP was identified. The exposure dose is an important factor in determining the toxic effects of mercury on hypertension. https://doi.org/10.1289/EHP2863
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Hu et al. meta-analysis suggests that hair mercury concentration of 2-3 μg/g might be considered as a threshold for risk of developing hypertension.
“Hu et al. [47] in a meta-analysis suggest that hair mercury concentration of 2–3 µg/g might be considered as a threshold for risk of developing hypertension.”
From Health Risk Assessment of Mercury Exposure from Fish Consumption in Munduruku Indigenous Communities in the Brazilian Amazon (2021) · cites this paper as Hu et al. [47]
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Greenland, S., & Longnecker, M. P. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116237 · Cited by 2,353 · see citing works
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Abhyankar, L. N., Jones, M. R., Guallar, E., & Navas-Acien, A. (2012) · Environmental Health Perspectives · doi:10.1289/ehp.1103988 · Cited by 281 · see citing works
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- Authors
- Hu, X. F., Singh, K., & Chan, H. M.
- Affiliations
- University of Ottawa (CA)
- Corresponding author
- Chan, Hing Man
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2018-07-01
- Volume
- 126
- Issue
- 7
- Pages
- 076002-076002
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC6108832
- OpenAlex
- W2886397848
- Cited by
- 146
- References
- 3
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 17 · 2023: 22 · 2022: 24 · 2021: 30 · 2020: 23 · 2019: 8 · 2018: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Government of Canada
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Mercury impact and mitigation studies
- 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
- mercury exposure, hypertension, blood pressure, hair mercury, dose-response relationship, mercury toxicity, systolic blood pressure, diastolic blood pressure
- MeSH terms
- Blood Pressure, Dose-Response Relationship, Drug, Environmental Exposure, Environmental Pollutants, Humans, Hypertension, Mercury, Prevalence, Proportional Hazards Models, Odds Ratio
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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