ArticleEnvironmental research2021
Arsenic, blood pressure, and hypertension in the Strong Heart Family Study.
Article in Environmental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 29 citations in OpenAlex.
- Environmental Exposures and Atherosclerotic Risk Factors in Vulnerable Youth: The Example of American Indian/Alaska Native Populations.Current atherosclerosis reports · 2026Review
- The Association of Arsenic Metabolism and Blood Pressure: A Cross-Sectional Analysis in the MesoAmerican Nephropathy Occupational Study (MANOS).Research square · 2026Article
- Soil health to human health: impacts of soil contaminants on cardio-neurological health and clinical outcomes: a narrative review.Frontiers in cardiovascular medicine · 2026Review
- Investigating the association between groundwater contaminants and hypertension risk in India: a machine learning-based analysis.Journal of exposure science & environmental epidemiology · 2026Article
- Improving American Indian Adolescent and Young Adult Cardiovascular Health: The Importance of the Strong Heart Family Study.Journal of the American Heart Association · 2025Review
- Article
- Depression and Incident Hypertension: The Strong Heart Family Study.Preventing chronic disease · 2025Article
- Metals on the Menu-Analyzing the Presence, Importance, and Consequences.Foods (Basel, Switzerland) · 2024Review
- Arsenic Exposure-Related Hypertension in Bangladesh and Reduced Circulating Nitric Oxide Bioavailability.Environmental health perspectives · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Association between Heavy Metals, Metalloids and Metabolic Syndrome: New Insights and Approaches.Toxics · 2023Review
- ARSENIC IN DRINKING WATER AND URINE AND ITS RELATIONSHIP WITH MALIGNANT TUMORS OF URINARY TRACT IN OSIJEK-BARANJA COUNTY, CROATIA.Acta clinica Croatica · 2023Article
- Short-term exposure to some heavy metals carried with PMScientific reports · 2023Article
- Potential Roles of Metals in the Pathogenesis of Pulmonary and Systemic Hypertension.International journal of biological sciences · 2023Review
- Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
12 authors at 11 institutions in 3 countries.
Funding
Abstract
backgroundArsenic has been associated with hypertension, though it is unclear whether associations persist at the exposure concentrations (e.g. <100 μg/L) in drinking water occurring in parts of the Western United States.
methodsWe assessed associations between arsenic biomarkers and systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension in the Strong Heart Family Study, a family-based cohort of American Indians from the Northern plains, Southern plains, and Southwest. We included 1910 participants from three study centers with complete baseline visit data (2001-2003) in the cross-sectional analysis of all three outcomes, and 1453 participants in the prospective analysis of incident hypertension (follow-up 2006-2009). We used generalized estimating equations with exchangeable correlation structure conditional on family membership to estimate the association of arsenic exposure biomarker levels with SBP or DBP (linear regressions) or hypertension prevalence and incidence (Poisson regressions), adjusting for urine creatinine, urine arsenobetaine, and measured confounders.
resultsWe observed cross-sectional associations for a two-fold increase in inorganic and methylated urine arsenic species of 0.64 (95% CI: 0.07, 1.35) mm Hg for SBP, 0.49 (95% CI: 0.03, 1.02) mm Hg for DBP, and a prevalence ratio of 1.10 (95% CI: 1.01, 1.21) for hypertension in fully adjusted models. During follow-up, 14% of subjects developed hypertension. We observed non-monotonic relationships between quartiles of arsenic and incident hypertension. Effect estimates were null for incident hypertension with continuous exposure metrics. Stratification by study site revealed elevated associations in Arizona, the site with the highest arsenic levels, while results for Oklahoma and North and South Dakota were largely null. Blood pressure changes with increasing arsenic concentrations were larger for those with diabetes at baseline.
conclusionsOur results suggest a modest cross-sectional association of arsenic exposure biomarkers with blood pressure, and possible non-linear effects on incident hypertension.
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