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The association of multiple whole blood metals with hypertension prevalence and blood pressure among general Chinese adults

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Overview

Cross-sectional study measuring whole-blood levels of 8 essential metals and 3 non-essential metals in 867 adults from Shiyan, China, using ICP-MS. Multivariable logistic/linear regression, restricted cubic splines, WQS, and BKMR were applied to examine associations of individual metals and mixtures with hypertension prevalence and blood pressure measures.

Key numbers

n=867 adults; 239 participants (29.5%) identified as hypertensive.

Mixture findings:

  • WQS and BKMR consistently showed a positive collective effect of eleven metals on hypertension; magnesium and iron were the top contributors.
  • WQS showed a positive combined effect of metal mixtures on systolic blood pressure and mean arterial pressure.
  • BKMR: the eight essential metals showed a stronger association with hypertension and blood pressure than the three non-essential metals.

Single-metal findings in multivariable logistic regression:

  • Magnesium: OR=2.19 (95% CI: 1.36, 3.54) for hypertension (highest vs lowest tertile).
  • Iron: OR=2.70 (95% CI: 1.62, 4.50) for hypertension (highest vs lowest tertile); beta=2.70 (95% CI: 0.88, 4.51) for mean arterial pressure.
  • Calcium: OR=0.58 (95% CI: 0.35, 0.94) for hypertension (inverse association).

Benjamini-Hochberg procedure used to correct for multiple testing; FDR-adjusted p below 0.05 deemed significant.

Evidence Fitness

Context only. Cross-sectional design. This is a Chinese adult cohort from a single city; associations may not generalize to other populations. The dominant role of essential metals (magnesium and iron) rather than the conventional toxic metals (lead and cadmium) in this population’s blood-pressure mixture effect is an important qualifier: the mixture effect on blood pressure does not exclusively implicate toxic metals.

Methods (brief)

Cross-sectional study, Shiyan, China. Whole blood metals by ICP-MS. Hypertension: SBP at least 140 mmHg or DBP at least 90 mmHg or antihypertensive use. BMI-based obesity classification: 24.0-27.9 kg/m2 overweight, at least 28.0 kg/m2 obese. Benjamini-Hochberg FDR correction applied to multiple testing.

Implications

Certification: Demonstrates that blood-metal mixture effects on blood pressure involve essential metals prominently; underscores that mixture effects are outcome- and population-specific rather than uniformly driven by toxic metals.

Courses: Useful for distinguishing toxic and essential metal roles in mixture epidemiology.

App: No food concentration data.

Microbiome: Not applicable.

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