Association Between Hypertension Incidence And The Level Of Urine Metals Among Adult Residents Living In Rural Areas Along The Yangtze River In Anhui Province

ObjectiveThe incidence of hypertension for adult residents living in rural areas along the Yangtze River in Anhui province was got through two years of follow-up.And the samples were collected at the baseline survey and detected to get the level of urine metals?arsenic?As?,chromium?Cr?,manganese?Mn?,cadmium?Cd?,zinc?Zn?,iron?Fe?and copper?Cu??of adult residents.The aim of this study was to explore the relationship between the level of urine metals?As,Cr,Mn,Cd,Zn,Fe and Cu?and incident hypertension through two years of follow-up.In order to provide the scientific basis for controlling of hypertension and environmental governance of the relevant local departments.MethodsA multistage-stratified random cluster sampling was conducted in this study from September 2014 to June 2015.Firstly,7 towns were randomly selected from Ma'anshan,Chizhou and Tongling,and then villages were randomly selected from the selected towns.The residents of selected villages aged 12 or above were enrolled in the investigation.A questionnaire was used to investigate the demographic characteristics,lifestyle and behavior of participants as well as physical examinations were conducted,and the urine samples were also collected on the next morning of each recruitment day.The urine As,Cr,Mn,Zn,Fe and Cu were tested by inductively coupled plasma optical emission spectrometer,while urine Cd was tested by graphite furnace atomic absorption spectrometry.In October 2016 to May 2017,we understood the change of lifestyle and incidence of hypertension for respondents through the follow-up survey.The?² test?Mann-Whitney test and Kaplan-Meier method were used to analyze the single factor,and explore the effect of the level of urine metals of adult residents for incident hypertension by using multivariable Cox proportional hazards regression.ResultsThere were 1358 adult residents who had no hypertension at the baseline in our two years follow-up study,whose average age was 46.04±15.30 months,592 people were male residents?43.6%?and 766 people were female residents?56.4%?.The average follow-up time was 25.09 months?24³2.4 months?.There were 275 new patients with new hypertension,the incidence of hypertension was 20.3%?197.68/1000 person months?.The level of As,Mn,Cd and Cu after creatinine correction in hypertension patients were 82.36?g/g?0.55?g/g?3.18?g/g and 15.06?g/g,were higher than that in residents with no hypertension?74.25?g/g?0.44?g/g?2.29?g/g and 13.27?g/g?.The hazard risk of residents with highest quantile of urine As,Cr,Mn,Cd and Cu were 1.49?1.05².12??1.44?1.08¹.91??1.66?1.24².21??1.45?1.00².14?and 1.43?1.08¹.88?compared with the residents in the reference group of corresponding metal.And the hazard risk of residents of urine As and Cd were 1.37?1.02¹.84?and 1.67?1.25².23?(?P₂₀ vs<P₂₀).ConclusionsThe level of urine metals?As,Cr,Mn,Cd,Zn,Fe and Cu?of adult residents living in rural areas along the Yangtze River in Anhui Province were higher,and the highest concentrations of urine As,Cr,Mn,Cd and Cu may increase the risk of incident hypertension.The comprehensive measures of environmental control should be taken to prevent and control the incidence of hypertension in rural adult residents living along the Yangtze River.