Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Int Arch Occup Environ Health. 2021 Aug;94(6):1137-1146. doi: 10.1007/s00420-021-01714-x. Epub 2021 May 20.
Previous studies showed controversial results of the relationship between fluoride exposure through drinking water and elevated blood pressure. We conducted a systematic review and meta-analysis to assess the direct relationship of drinking water fluoride exposure with blood pressure and essential hypertension prevalence in general populations.
We conducted a systematic search in databases including Web of Knowledge, PubMed, Scopus, and Embase by MeSH and non-MeSH terms for relevant studies with any design published until August 2019, with no limitation in time and language. The pooled effect measure was calculated within a 95% confidence interval (CI).
Our search retrieved 630 journal articles, six of which were eligible for data extraction. The random-effects model found significantly higher systolic blood pressure (mean difference = 6.49 mmHg; 95% CI 3.73-9.25; p value < 0.01) and diastolic blood pressure (mean difference = 4.33 mmHg; 95% CI 1.39-7.26; p value < 0.01) in groups exposed to high-fluoride drinking water than in groups exposed to normal/low-fluoride drinking water. A significant relationship was also found between high-fluoride drinking water and essential hypertension (odds ratio = 2.14; 95% CI 1.02-4.49; p value = 0.045).
The risk of elevated blood pressure increases in the general population of fluoride endemic areas. However, more research is needed to make a firm conclusion about the adverse effects of excess fluoride intake on the cardiovascular system at the individual level.
既往研究表明，饮水型氟暴露与血压升高之间的关系存在争议。我们进行了一项系统评价和荟萃分析，以评估一般人群中饮水型氟暴露与血压和原发性高血压患病率之间的直接关系。
我们通过 MeSH 和非 MeSH 术语，在包括 Web of Knowledge、PubMed、Scopus 和 Embase 在内的数据库中进行了系统检索，检索了截至 2019 年 8 月发表的任何设计的相关研究，对时间和语言没有限制。汇总效应量在 95%置信区间（CI）内计算。
我们的检索共获得了 630 篇期刊文章，其中 6 篇符合数据提取标准。随机效应模型发现，暴露于高氟饮用水组的收缩压（均数差=6.49mmHg；95%CI 3.73-9.25；p 值<0.01）和舒张压（均数差=4.33mmHg；95%CI 1.39-7.26；p 值<0.01）均显著高于暴露于正常/低氟饮用水组。高氟饮用水与原发性高血压之间也存在显著相关性（比值比=2.14；95%CI 1.02-4.49；p 值=0.045）。
在氟中毒流行地区的一般人群中，血压升高的风险增加。然而，需要更多的研究来确定个体水平过量氟摄入对心血管系统的不良影响。
