Carrasco-Rios M, Ortolá R, Sotos-Prieto M, Graciani A, Rodríguez-Artalejo F, Banegas J R, García-Esquinas E
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Environ Res. 2023 May 15;225:115625. doi: 10.1016/j.envres.2023.115625. Epub 2023 Mar 7.
Potential environmental determinants of BP and hypertension in older adults are far less known than their lifestyle risk factors. Manganese (Mn) is an essential element for life that may induce changes in blood pressure (BP), but the direction of the association is unclear. We aimed to examine the association of blood manganese (bMn) with 24-h-based brachial, central BP (cBP), and pulse-wave velocity (PWV). With this purpose, we analyzed data from 1009 community-living adults aged >65 years without BP medication. bMn was measured using inductively-coupled plasma-mass spectrometry and 24-h BP with validated devices. The association of bMn (median: 6.77 μg/L; IQR: 5.59-8.27) with daytime brachial and central systolic (SBP) and with diastolic BP (DBP) was non-linear, with BP increases up to around the median of Mn and then stabilization or slight rightward decrease. Mean BP differences (95% confidence interval) comparing Mn Q2 to Q5 (vs Q1 quintile) for brachial daytime SBP were 2.56 (0.22; 4.90), 3.59 (1.22; 5.96), 3.14 (0.77; 5.51) and 1.72 (-0.68; 4.11) mmHg, respectively; and 2.22 (0.70, 3.73), 2.55 (1.01, 4.08), 2.45 (0.91; 3.98), and 1.68 (0.13; 3.24), respectively, for DBP. Daytime central-pressures showed a similar dose-response relationship with bMn as daytime brachial-pressures. The association with nighttime BP was linearly positive for brachial BPs, and only increasing for Q5 for cBP. Regarding PWV, a tendency to significant linear increase along bMn levels was observed (p-trend = 0.042). The present findings extend the scarce evidence on the association between Mn and brachial BP to 2 other vascular parameters, suggesting Mn levels as a candidate risk factor for increasing levels of both brachial and cBPs in older adults, yet further research is needed with larger cohort studies in adults at all age ranges.
老年人血压和高血压潜在的环境决定因素远不如其生活方式风险因素为人所知。锰（Mn）是一种生命必需元素，可能会引起血压（BP）变化，但其关联方向尚不清楚。我们旨在研究血锰（bMn）与基于24小时的肱动脉血压、中心血压（cBP）和脉搏波速度（PWV）之间的关联。为此，我们分析了1009名年龄大于65岁且未服用降压药物的社区居住成年人的数据。使用电感耦合等离子体质谱法测量bMn，并用经过验证的设备测量24小时血压。bMn（中位数：6.77μg/L；四分位间距：5.59 - 8.27）与白天肱动脉收缩压和中心收缩压（SBP）以及舒张压（DBP）之间的关联是非线性的，血压在锰含量中位数左右之前升高，然后趋于稳定或略有下降。将锰含量第二分位数至第五分位数（与第一分位数相比）的白天肱动脉SBP平均血压差异（95%置信区间）分别为2.56（0.22；4.90）、3.59（1.22；5.96）、3.14（0.77；5.51）和1.72（ - 0.68；4.11）mmHg；DBP的平均血压差异分别为2.22（0.70，3.73）、2.55（1.01，4.08）、2.45（0.91；3.98）和1.68（0.13；3.24）。白天中心血压与bMn的剂量反应关系与白天肱动脉血压相似。夜间肱动脉血压与bMn呈线性正相关，夜间中心血压仅在锰含量第五分位数时升高。关于PWV，观察到随着bMn水平有显著线性升高的趋势（p趋势 = 0.042）。目前的研究结果将关于锰与肱动脉血压之间关联的稀少证据扩展到另外两个血管参数，表明锰水平可能是老年人肱动脉血压和中心血压升高的一个潜在风险因素，但还需要在所有年龄段的成年人中进行更大规模的队列研究。
