Longitudinal blood pressure changes in relation to urinary toxic/essential metals and metal mixtures

Hypertension is the number one driver of cardiovascular disease, the leading cause of mortality. Emerging evidence identifies metal exposures as potential contributors to elevated blood pressure, but few studies have assessed longitudinal changes in blood pressure. Furthermore, Hispanics/Latinos face a disproportionate burden of both metal exposures and uncontrolled and early onset hypertension, yet they remain underrepresented in environmental epidemiology research.

Evaluate associations between blood pressure traits in relation to baseline toxic metals, essential metals, and metal mixture exposures among 372 Mexican American adults.

Utilizing a longitudinal cohort, 372 adults were followed for 3 years with 6 repeated examinations. Linear mixed effects models were used to estimate the monthly increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) in relation to higher baseline metal concentrations. Principal component analysis was utilized to assess the effects of the metal mixtures both as a total mixture and categorized into toxic and essential metal components.

Overall, single metal models identified arsenic, cadmium, cobalt, and molybdenum with increases in blood pressure traits. Specifically, arsenic was associated with increased SBP. Cadmium, molybdenum and cobalt were associated with increased PP. Selenium was associated with reduction in DBP. The metal mixture showed no significant co-exposure patterns.

Individual toxic and essential metals were associated with changes in blood pressure. These findings offer insights into the environmental determinants of hypertension pathogenesis in vulnerable populations.