ArticleFrontiers in public health2023
Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China.
Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Dose-response association between circulating selenium and blood pressure: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Association of Blood Manganese and Preeclampsia: A Systematic Review and Meta-analysis.Biological trace element research · 2024Pooled it
- Beyond genetics: how environmental stressors drive pediatric hypertension risk.Pediatric nephrology (Berlin, Germany) · 2026Review
- The Association of Arsenic Metabolism and Blood Pressure: A Cross-Sectional Analysis in the MesoAmerican Nephropathy Occupational Study (MANOS).Research square · 2026Article
- The association of multiple whole blood metals with hypertension prevalence and blood pressure among general Chinese adults.Nutrition journal · 2026Article
- Association between serum Copper-Zinc-Selenium mixture and multiple health outcomes.Bioactive materials · 2025Article
- Effect of combined exposure to lead, mercury, and cadmium on hypertension: The 2008-2013 Korean National Health and Nutrition Examination Surveys.International journal of occupational medicine and environmental health · 2025Article
- Impact of multi-metal exposure on blood pressure: a mediation analysis through oxidative stress markers in China's Southern Jiangxi Province.BMC public health · 2025Article
- Article
- Evidence Linking Cadmium Exposure and βToxics · 2023Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Environmental exposure to multiple metals have been inconsistently associated with hypertension. Obesity is an important independent risk factor for hypertension, and few studies have assessed the interaction between obesity and metals in this context. We aimed to clarify their association and interaction. Methods: This cross-sectional study included 3,063 adults from 11 districts or counties, Guangdong. We measured the whole blood levels of 13 metals and used multipollutant-based statistical methods to analyze the association of metals with hypertension. The interaction between metals and obesity on hypertension was assessed on additive and multiplicative scales. Results: Four metals (manganese, arsenic, cadmium, and lead) were significantly associated with hypertension risk, five metals (manganese, zinc, arsenic, cadmium, and lead) were related to elevated SBP levels, five metals (manganese, zinc, selenium, cadmium, and lead) were associated with elevated DBP levels in single-metal model. Manganese remained significantly related to hypertension risk [odds ratio, 1.35 (1.02-1.78)] after adjusting for these four metals. Significant positive dose-response relationships between manganese, arsenic, cadmium, lead and hypertension risk were observed ( Conclusions: The combined effect of four metals (manganese, arsenic, cadmium and lead) were associated with the prevalence of hypertension. Potential interaction effects of cadmium, lead and obesity on hypertension risk may exist. Further cohort studies in larger population are needed to clarify these findings.
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