Scheelbeek Pauline FD, Chowdhury Muhammad A H, Haines Andy, Alam Dewan S, Hoque Mohammad A, Butler Adrian P, Khan Aneire E, Mojumder Sontosh K, Blangiardo Marta A G, Elliott Paul, Vineis Paolo
Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
MRC-PHE Centre for Environment and Health, London, UK
Environ Health Perspect. 2017 May 30;125(5):057007. doi: 10.1289/EHP659.
Millions of coastal inhabitants in Southeast Asia have been experiencing increasing sodium concentrations in their drinking-water sources, likely partially due to climate change. High (dietary) sodium intake has convincingly been proven to increase risk of hypertension; it remains unknown, however, whether consumption of sodium in drinking water could have similar effects on health.
We present the results of a cohort study in which we assessed the effects of drinking-water sodium (DWS) on blood pressure (BP) in coastal populations in Bangladesh.
DWS, BP, and information on personal, lifestyle, and environmental factors were collected from 581 participants. We used generalized linear latent and mixed methods to model the effects of DWS on BP and assessed the associations between changes in DWS and BP when participants experienced changing sodium levels in water, switched from "conventional" ponds or tube wells to alternatives [managed aquifer recharge (MAR) and rainwater harvesting] that aimed to reduce sodium levels, or experienced a combination of these changes.
DWS concentrations were highly associated with BP after adjustments for confounding factors. Furthermore, for each 100 mg/L reduction in sodium in drinking water, systolic/diastolic BP was lower on average by 0.95/0.57 mmHg, and odds of hypertension were lower by 14%. However, MAR did not consistently lower sodium levels.
DWS is an important source of daily sodium intake in salinity-affected areas and is a risk factor for hypertension. Considering the likely increasing trend in coastal salinity, prompt action is required. Because MAR showed variable effects, alternative technologies for providing reliable, safe, low-sodium fresh water should be developed alongside improvements in MAR and evaluated in "real-life" salinity-affected settings. https://doi.org/10.1289/EHP659.
东南亚数百万沿海居民的饮用水源中钠浓度不断上升，这可能部分归因于气候变化。高（饮食）钠摄入量已被确凿证明会增加患高血压的风险；然而，饮用水中的钠摄入是否会对健康产生类似影响仍不清楚。
我们展示了一项队列研究的结果，该研究评估了孟加拉国沿海地区饮用水钠（DWS）对血压（BP）的影响。
收集了581名参与者的DWS、BP以及个人、生活方式和环境因素的信息。我们使用广义线性潜在和混合方法对DWS对BP的影响进行建模，并评估了参与者在水中钠水平变化、从“传统”池塘或管井切换到旨在降低钠水平的替代水源[人工回灌含水层（MAR）和雨水收集]或经历这些变化的组合时，DWS变化与BP之间的关联。
在对混杂因素进行调整后，DWS浓度与BP高度相关。此外，饮用水中钠含量每降低100 mg/L，收缩压/舒张压平均分别降低0.95/0.57 mmHg，患高血压的几率降低14%。然而，MAR并没有持续降低钠水平。
在受盐度影响的地区，DWS是日常钠摄入的重要来源，也是高血压的一个风险因素。鉴于沿海盐度可能呈上升趋势，需要迅速采取行动。由于MAR的效果不一，应在改进MAR的同时开发提供可靠、安全、低钠淡水的替代技术，并在“现实生活”中受盐度影响的环境中进行评估。https://doi.org/10.1289/EHP659。
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