Association between cadmium and lead co-exposure, blood pressure, and hypertension: a cross-sectional study from northwest China

Abstract

Cadmium (Cd) and lead (Pb) co-exposure have been inconsistently associated with blood pressure (BP) and hypertension (HTN). This cross-sectional study included 309 participants who completed a health examination and had blood Cd (Cd-B) and Pb (Pb-B) levels measured. The association between Cd, Pb, and their combined exposure levels, with systolic (SBP) and diastolic blood pressure (DBP) and HTN was evaluated using models which were stratified according to sex, age, BMI, and smoking habit categories. The results found both increasing Cd-B and Pb-B were associated with elevated SBP and DBP in the overall population. In addition, increases in Cd-B and Pb-B were also associated with increased risk of HTN in overall and stratified models. Moreover, compared with the low exposure group, co-exposure to high levels of Cd and Pb was associated with increased SBP (β = 10.95, 95% CI: 5.69, 16.21), increased DBP (β = 5.09, 95% CI: 1.53, 8.66), and increased HTN risk (OR = 2.45, 95% CI: 1.15, 5.21) in the overall model, and above results were different in the stratified model. This study provides evidence of an association between Cd and/or Pb exposure levels, BP, and HTN. However, the significance of this association differed according to sex, age, BMI, and smoking habit. Highlights Cadmium/lead exposure is associated with elevated blood pressure and hypertension. Cadmium and lead co-exposure increased blood pressure in a dose-dependent manner. Results revealed differences according to sex, age, BMI, and smoking habit category. Health oversight should be implemented for residents with high heavy metal exposure.