Association between Hypertension and Chronic Arsenic Exposure in Drinking Water: A Cross-Sectional Study in Bangladesh

Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged >= 30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure >= 140 mmHg (systolic hypertension) and diastolic blood pressure >= 90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was >= 55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1-8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure > 50 mu g/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and > 50 mu g/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46-8.57), as did arsenic exposure for >= 10 years (adjusted OR: 5.25, 95% CI: 1.41-19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.