Higher Urinary Heavy Metal, Phthalate, and Arsenic but Not Parabens Concentrations in People with High Blood Pressure, US NHANES, 2011-2012

Link between environmental chemicals and human health has emerged but not been completely examined in risk factors. Therefore, it was aimed to study the relationships of different sets of urinary environmental chemical concentrations and risk of high blood pressure (BP) in a national, population-based study. Data were retrieved from United States National Health and Nutrition Examination Surveys, 2011-2012 including demographics, BP readings, and urinary environmental chemical concentrations. Analyses included chi-square test, t-test and survey-weighted logistic regression modeling. After full adjustment (adjusting for urinary creatinine, age, sex, ethnicity, and body mass index), urinary cesium (OR 1.56, 95% CI 1.11-2.20, P = 0.014), molybden (OR 1.46, 95% CI 1.06-2.01, P = 0.023), manganese (OR 1.42, 95% CI 1.09-1.86, P = 0.012), lead (OR 1.58, 95% CI 1.28-1.96, P < 0.001), tin (OR 1.44, 95% CI 1.25-1.66, P < 0.001), antimony (OR 1.39, 95% CI 1.10-1.77, P = 0.010), and tungsten (OR 1.49, 95% CI 1.25-1.77, P < 0.001) concentrations were observed to be associated with high BP. People with higher urinary mono-2-ethyl-5-carboxypentyl phthalate (OR 1.33, 95% CI 1.00-1.62, P = 0.006), mono-n-butyl phthalate (OR 1.35, 95% CI 1.13-1.62, P = 0.002), mono-2-ethyl-5-hydroxyhexyl (OR 1.25, 95% CI 1.05-1.49, P = 0.014), mono-n-methyl phthalate (OR 1.26, 95% CI 1.07-1.48, P = 0.007), mono-2-ethyl-5-oxohexyl (OR 1.25, 95% CI 1.07-1.48, P = 0.009), and monobenzyl phthalate (OR 1.40, 95% CI 1.15-1.69, P = 0.002) tended to have high BP as well. However, there are no clear associations between environmental parabens and high BP, nor between pesticides and high BP. In addition, trimethylarsine oxide (OR 2.47, 95% CI 1.27-4.81, P = 0.011) and dimethylarsonic acid concentrations (OR 1.42, 95% CI 1.12-1.79, P = 0.006) were seen to be associated with high BP. In sum, urinary heavy metal, phthalate, and arsenic concentrations were associated with high BP, although the causal effect cannot be established from the current study design. Elimination of environmental chemicals in humans would still need to be continued.