ArticleEnvironmental health perspectives2012
Associations of toenail arsenic, cadmium, mercury, manganese, and lead with blood pressure in the normative aging study.
Article in Environmental health perspectives, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
68 citing papers in PubMed, 5 syntheses or guidelines pooled it, 134 citations in OpenAlex.
- Re-thinking the link between exposure to mercury and blood pressure.Archives of toxicology · 2025Pooled it
- The association between environmental cadmium exposure, blood pressure, and hypertension: a systematic review and meta-analysis.Environmental science and pollution research international · 2022Pooled it
- Toenails as a biomarker of exposure to arsenic: A review.Environmental research · 2021Pooled it
- An updated systematic review on the association between Cd exposure, blood pressure and hypertension.Ecotoxicology and environmental safety · 2021Pooled it
- Mercury Exposure, Blood Pressure, and Hypertension: A Systematic Review and Dose-response Meta-analysis.Environmental health perspectives · 2018Pooled it
- A Novel DLLME-Based Approach for the Spectrophotometric Determination of Mercury in Environmental Samples Using the Fe(II) Phthalocyanine Sensor.Molecules (Basel, Switzerland) · 2025Article
- Exposure to Multiple Metal(loid)s and Hypertension in Chinese Older Adults.Biological trace element research · 2025Article
- The association between toenail metals and extracellular MicroRNAs (ex-miRNAs) among the participants of the Normative Aging study (NAS).Environmental research · 2024Article
- Associations of a toenail metal mixture with attention and memory in the Gulf long-term follow-up (GuLF) study.The Science of the total environment · 2024Article
- Association between lead and circulating markers of inflammation among traffic enforcers in Metro Manila, Philippines: the MMDA traffic enforcer's health study.International archives of occupational and environmental health · 2024Article
- Review Article on Molecular Mechanism of Regulation of Hypertension by Macro-elements (Na, K, Ca and Mg), Micro-elements/Trace Metals (Zn and Cu) and Toxic Elements (Pb and As).Biological trace element research · 2024Review
- Benchtop x-ray fluorescence to quantify elemental content in nails non-destructively.The Science of the total environment · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Bacterial Modification of the Association Between Arsenic and Autism-Related Social Behavior Scores.Exposure and health · 2023Article
- Individual, Independent, and Joint Associations of Toxic Metals and Manganese on Hypertensive Disorders of Pregnancy: Results from the MIREC Canadian Pregnancy Cohort.Environmental health perspectives · 2023Article
- Epigenome-wide DNA methylation in leukocytes and toenail metals: The normative aging study.Environmental research · 2023Article
- Metals and risk of incident metabolic syndrome in a prospective cohort of midlife women in the United States.Environmental research · 2022Article
- Adult Exposures to Toxic Trace Elements as Measured in Nails along the Interoceanic Highway in the Peruvian Amazon.International journal of environmental research and public health · 2022Article
- Validation of in vivo toenail measurements of manganese and mercury using a portable X-ray fluorescence device.Journal of exposure science & environmental epidemiology · 2022Article
- Arsenic Speciation and Metallomics Profiling of Human Toenails as a Biomarker to Assess Prostate Cancer Cases: Atlantic PATH Cohort Study.Frontiers in public health · 2022Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundArsenic, cadmium, mercury, and lead are associated with cardiovascular disease in epidemiologic research. These associations may be mediated by direct effects of the metals on blood pressure (BP) elevation. Manganese is associated with cardiovascular dysfunction and hypotension in occupational cohorts.
objectivesWe hypothesized that chronic arsenic, cadmium, mercury, and lead exposures elevate BP and that manganese lowers BP.
methodsWe conducted a cross-sectional analysis of associations between toenail metals and BP among older men from the Normative Aging Study (n = 639), using linear regression and adjusting for potential confounders.
resultsAn interquartile range increase in toenail arsenic was associated with higher systolic BP [0.93 mmHg; 95% confidence interval (CI): 0.25, 1.62] and pulse pressure (0.76 mmHg; 95% CI: 0.22, 1.30). Positive associations between arsenic and BP and negative associations between manganese and BP were strengthened in models adjusted for other toenail metals.
conclusionsOur findings suggest associations between BP and arsenic and manganese. This may be of public health importance because of prevalence of both metal exposure and cardiovascular disease. Results should be interpreted cautiously given potential limitations of toenails as biomarkers of metal exposure.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.