Blood Cadmium Levels and Hypertension Prevalence: a Cross-Sectional Study using NHANES
Abstract
Introduction and Objective. Metals like cadmium have been hypothesized to be implicated in the pathogenesis of cardiovascular disease, affecting various physiological measurements and cellular components via increased production of reactive oxidative species and activation of apoptosis. Our study aims to determine if in adults aged 18 to 79 living in the United States, elevated blood concentration of cadmium, when compared to lower blood concentration of cadmium, is associated with prevalent hypertension. Methods. We conducted a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2017-2020 data, including people aged 18 to 79. We excluded pregnant individuals and those missing pertinent data. Blood cadmium was measured using inductively coupled plasma mass spectrometry. Hypertension was defined as having an average of three blood pressure measurements greater than 130/80 or being told so at least twice by a healthcare professional. We performed bivariate analyses to assess a crude relationship between quartiles (Q1-Q4) of blood cadmium levels and hypertension prevalence, and a multivariate regression analysis to explore this relationship while adjusting for the following confounders: age, gender, race, ethnicity, income, menopausal status, smoking, and high-sensitivity C-reactive protein (hs-CRP) levels. Results. There were 7563 participants included, averaging 48.9 years old, of which 50.6% were women. The overall prevalence of hypertension was 42.7%. The median blood cadmium level was 0.296 ng/mL, with an IQR of 0.37 ng/mL. There were statistically significant relationships (OR, [95%CI]) between hypertension and Black race (OR=1.60, [1.17-2.18]), hs-CRP >3 mg/L (OR=1.68, [1.26-2.25]), elevated urine albumin >30 mg/L (OR=2.69, [2.08-3.46]), and stroke history (OR=3.94, [1.91-8.09]). We found significantly higher prevalence of hypertension in higher blood cadmium quartiles (30.4% in Q1, 45.2% in Q4; p < 0.001). Upon multivariate adjustment for confounders, there was no significant association between elevated blood cadmium levels and hypertension. Conclusions-Implications. Our study found no significant association between elevated blood cadmium levels and hypertension in a United States adult population. These findings challenge previous mechanistic studies and do not support the presumed benefit of cadmium chelation therapy for patients with hypertension. Further research is warranted to explore the relationships between heavy metals, cardiovascular health, and other associated risk factors.
Abstract Category
3. Cardiology
Secondary Abstract Category
27. Public Health
Keywords
heavy metals, public health, hypertension, cadium
Presentation Type
Poster Presentation
Blood Cadmium Levels and Hypertension Prevalence: a Cross-Sectional Study using NHANES
Introduction and Objective. Metals like cadmium have been hypothesized to be implicated in the pathogenesis of cardiovascular disease, affecting various physiological measurements and cellular components via increased production of reactive oxidative species and activation of apoptosis. Our study aims to determine if in adults aged 18 to 79 living in the United States, elevated blood concentration of cadmium, when compared to lower blood concentration of cadmium, is associated with prevalent hypertension. Methods. We conducted a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2017-2020 data, including people aged 18 to 79. We excluded pregnant individuals and those missing pertinent data. Blood cadmium was measured using inductively coupled plasma mass spectrometry. Hypertension was defined as having an average of three blood pressure measurements greater than 130/80 or being told so at least twice by a healthcare professional. We performed bivariate analyses to assess a crude relationship between quartiles (Q1-Q4) of blood cadmium levels and hypertension prevalence, and a multivariate regression analysis to explore this relationship while adjusting for the following confounders: age, gender, race, ethnicity, income, menopausal status, smoking, and high-sensitivity C-reactive protein (hs-CRP) levels. Results. There were 7563 participants included, averaging 48.9 years old, of which 50.6% were women. The overall prevalence of hypertension was 42.7%. The median blood cadmium level was 0.296 ng/mL, with an IQR of 0.37 ng/mL. There were statistically significant relationships (OR, [95%CI]) between hypertension and Black race (OR=1.60, [1.17-2.18]), hs-CRP >3 mg/L (OR=1.68, [1.26-2.25]), elevated urine albumin >30 mg/L (OR=2.69, [2.08-3.46]), and stroke history (OR=3.94, [1.91-8.09]). We found significantly higher prevalence of hypertension in higher blood cadmium quartiles (30.4% in Q1, 45.2% in Q4; p < 0.001). Upon multivariate adjustment for confounders, there was no significant association between elevated blood cadmium levels and hypertension. Conclusions-Implications. Our study found no significant association between elevated blood cadmium levels and hypertension in a United States adult population. These findings challenge previous mechanistic studies and do not support the presumed benefit of cadmium chelation therapy for patients with hypertension. Further research is warranted to explore the relationships between heavy metals, cardiovascular health, and other associated risk factors.