The Effects of Alcohol Drinking and Environmental Cadmium Exposure on Hypertension in the Korean Adults: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2013

Abstract

Background/Aim Hypertension is a common disease found in one-third of Korean adults. Although previous studies have reported that high-risk drinking and cadmium exposure are risk factors for hypertension, most of these studies were limited to small populations or occupational workers exposed to a high concentration. Several studies that presented the joint effect of combined exposure of alcohol drinking and cadmium exposure on hypertension were also mainly conducted on animal experiments. This study will verify the individual effects of alcohol drinking and cadmium in the body and the joint effect of their co-exposure on hypertension in the general population.Methods We analyzed data from 6,795 Korean adults who had been randomly assigned to the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2013. Multiple linear and logistic regression analysis was conducted to estimate the association of alcohol drinking and blood cadmium concentration with blood pressure and odds ratio (OR) for hypertension.Results After adjusting for age, sex, smoking status, monthly income, education level, body mass index, stress level, physical activity, sodium intake, and the energy intake, ORs for hypertension comparing the group with high-risk alcohol drinking versus the group who did not was 1.67 (95% CI: 1.34, 2.06). In the same model, ORs for hypertension comparing the highest versus the lowest blood cadmium quartiles were 1.46 (95% CI: 1.15, 1.86), increasing significantly as cadmium concentration increased (p for trend <0.001). The results of logistic regression analysis for the additive scale of joint effects, ORs for interaction term was 0.64 (95% CI: 0.14, 1.14, p-value=0.011).Conclusions This study supports the hypothesis that alcohol drinking and environmental cadmium exposures at levels currently observed in the Korea may increase the risk of hypertension. Our findings support efforts to reduce alcohol drinking and environmental cadmium exposure to prevent hypertension in the general population effectively.