(Hypertension. 1999;33:74-78.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Hypertension and Arsenic Exposure in Bangladesh
From the Division of Occupational and Environmental Medicine (M.R., M.T., O.A.), Department of Health & Environment, Faculty of Health Sciences, Linköping University, Linköping, Sweden; the Department of Occupational and Environmental Health (S.A.A., M.H.F.), National Institute of Preventive and Social Medicine, Mohakhali, Dhaka 1212, Bangladesh; and the Radda-MCH FP Center, Mirpur (I.A.C.), Dhaka, 1216, Bangladesh.
Abstract—A prevalence comparison
of hypertension among subjects with and those without arsenic exposure
through drinking water was conducted in Bangladesh to confirm or refute
an earlier observation of a relation in this respect. Wells with and
without present arsenic contamination were identified, and we
interviewed and examined 1595 subjects who were depending on drinking
water from these wells for living, all 
30 years of age. The interview
was based on a questionnaire, and arsenic exposure was estimated from
the history of well-water consumption and current arsenic levels. Of
the 1595 subjects studied, 1481 had a history of arsenic-contaminated
drinking water, whereas 114 had not. Time-weighted mean arsenic levels
(in milligrams per liter) and milligram-years per liter of
arsenic exposure were estimated for each subject. Exposure categories
were assessed as <0.5 mg/L, 0.5 to 1.0 mg/L, and >1.0 mg/L and
alternatively as <1.0 mg-y/L, 1.0 to 5.0 mg-y/L, >5.0 but 
10.0
mg-y/L, and >10.0 mg-y/L, respectively. Hypertension was defined as a
systolic blood pressure of 140 mm Hg in combination
with a diastolic blood pressure of 90 mm Hg.
Corresponding to the exposure categories, and using "unexposed" as
the reference, the prevalence ratios for hypertension adjusted for age,
sex, and body mass index were 1.2, 2.2, 2.5 and 0.8, 1.5, 2.2, 3.0, in
relation to arsenic exposure in milligrams per liter and
milligram-years per liter, respectively. The indicated dose-response
relationships were significant (P
0.001) for both
series of risk estimates. These results suggest that arsenic exposure
may induce hypertension in humans.
Key Words: body mass index • environment • epidemiology • arsenic • water consumption • risk factors • vascular diseases
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