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Published on: May 3, 2018
Association of blood manganese concentrations with 24-h based brachial and central blood pressure, and pulse-wave
M Carrasco-Rios1, R Ortolá2, M Sotos-Prieto3
1Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
Abstract:
Potential environmental determinants of BP and hypertension in older adults are far less known than their lifestyle risk factors. Manganese (Mn) is an essential element for life that may induce changes in blood pressure (BP), but the direction of the association is unclear. We aimed to examine the association of blood manganese (bMn) with 24-h-based brachial, central BP (cBP), and pulse-wave velocity (PWV). With this purpose, we analyzed data from 1009 community-living adults aged >65 years without BP medication. bMn was measured using inductively-coupled plasma-mass spectrometry and 24-h BP with validated devices. The association of bMn (median: 6.77 μg/L; IQR: 5.59-8.27) with daytime brachial and central systolic (SBP) and with diastolic BP (DBP) was non-linear, with BP increases up to around the median of Mn and then stabilization or slight rightward decrease. Mean BP differences (95% confidence interval) comparing Mn Q2 to Q5 (vs Q1 quintile) for brachial daytime SBP were 2.56 (0.22; 4.90), 3.59 (1.22; 5.96), 3.14 (0.77; 5.51) and 1.72 (-0.68; 4.11) mmHg, respectively; and 2.22 (0.70, 3.73), 2.55 (1.01, 4.08), 2.45 (0.91; 3.98), and 1.68 (0.13; 3.24), respectively, for DBP. Daytime central-pressures showed a similar dose-response relationship with bMn as daytime brachial-pressures. The association with nighttime BP was linearly positive for brachial BPs, and only increasing for Q5 for cBP. Regarding PWV, a tendency to significant linear increase along bMn levels was observed (p-trend = 0.042). The present findings extend the scarce evidence on the association between Mn and brachial BP to 2 other vascular parameters, suggesting Mn levels as a candidate risk factor for increasing levels of both brachial and cBPs in older adults, yet further research is needed with larger cohort studies in adults at all age ranges.
Insights
Blood manganese (bMn) levels are associated with increased blood pressure (BP) in older adults. Higher bMn concentrations correlate with elevated brachial and central BP, and pulse-wave velocity, suggesting manganese as a potential cardiovascular risk factor.
Area of Science:
- Environmental health
- Cardiovascular research
- Gerontology
Background:
- Environmental factors influencing blood pressure (BP) and hypertension in older adults are understudied compared to lifestyle risks.
- Manganese (Mn), an essential element, has an unclear association with BP changes.
Purpose of the Study:
- To investigate the relationship between blood manganese (bMn) levels and 24-hour brachial BP, central BP (cBP), and pulse-wave velocity (PWV).
- To explore potential environmental determinants of cardiovascular health in aging populations.
Main Methods:
- Analysis of data from 1009 community-dwelling adults over 65 years old, not on BP medication.
- Measurement of blood manganese (bMn) using inductively-coupled plasma-mass spectrometry.
- Assessment of 24-hour BP and pulse-wave velocity (PWV) using validated devices.
Main Results:
- A non-linear association was observed between bMn and daytime brachial/central systolic and diastolic BP, with increases up to the median bMn level.
- Significant positive associations were found between bMn quintiles and brachial BP, with increases ranging from 1.72 to 3.59 mmHg.
- A tendency towards a significant linear increase in PWV was observed with rising bMn levels (p-trend = 0.042).
Conclusions:
- Blood manganese levels may be a risk factor for elevated brachial and central BP in older adults.
- The findings extend evidence on Mn's association with BP to other vascular parameters like cBP and PWV.
- Further research with larger cohorts across all age ranges is warranted to confirm these associations.
Related Concept Videos
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:24Blood Pressure
01:17Measurement of Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.