Exposure to metal mixtures and blood pressure among Bangladeshi children aged 5-7 years

Abstract

Background: Early life elevated blood pressure has been linked to hypertension later in life, a significant risk factor for cardiovascular disease. However, evidence connecting metal exposures to childhood blood pressure is limited, and most of the existing research has focused on evaluating the toxicity of one or two metals. Aim: This study aims to evaluate the associations between exposure to metal mixtures and blood pressure among Bangladeshi children aged 5-7 years. Methods: We investigated the associations between 17 metals, measured in toenails, and blood pressure using linear regression models (single-metal model and mutually-adjusted model). Additionally, principal component analysis (PCA), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were conducted as secondary analyses to test the robustness of findings and potential exposure patterns. Results: Selenium and mercury were positively and inversely, respectively, associated with diastolic blood pressure in linear regression models in the overall study population and among boys. While for girls, we observed an inverse association of tin with systolic blood pressure and a positive association of copper with diastolic blood pressure. Secondary analyses examining metal mixtures yielded similar results. Furthermore, interactions between metals were not found. Conclusions: Findings from linear regression modeling and secondary analyses using PCA, WQS, and BKMR, suggest an important role for selenium with childhood blood pressure, especially among boys. Future research is needed to understand better the mechanisms underlying these possible sex-specific effects of metal mixtures.