Association Between Multiple Plasma Toxic Metal and Metalloid Exposures and Hypertension in Elderly Chinese Adults.

Although environmental exposure to toxic metals and metalloids is linked with the risk of cardiovascular diseases, the evidence is limited in the elderly. We evaluated the associations between 12 plasma metal levels including aluminum (Al), titanium (Ti), strontium (Sr), lead (Pb), vanadium (V), chromium (Cr), cobalt (Co), nickel (Ni), cuprum (Cu), zinc (Zn), arsenic (As), and selenium (Se) with prevalence of hypertension in the elderly Chinese population. In this study, stratified cluster sampling was conducted among elderly residents in three communities in Gansu province from June to July 2023, with a total of 330 participants included. The concentrations of metals in whole plasma were measured using inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression and restricted cubic spline analyses were used to evaluate the dose-response relationship between plasma metal levels and hypertension, with all metal concentrations log-transformed. We applied quantile g-computation (QG-comp) and Bayesian kernel machine regression (BKMR) models to examine the associations of both individual metals and metal mixtures with hypertension. After multivariable adjustments, the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension associated with the highest quartile of metal concentrations compared to the lowest quartile were as follows: 4.20 (1.36, 12.98) for Sr, 3.95 (1.30, 12.03) for V, 3.43 (1.09, 10.78) for Cr, 3.28 (1.16, 9.28) for Cu, 3.28 (1.13, 9.52) for Zn, and 2.87 (0.94, 8.74) for As. Using BKMR and restricted cubic spline analysis, we found that exposure to metal mixtures was positively associated with an increased risk of hypertension, with Ni, Cr, As, and V being the primary contributing factors. In addition, Zn, Ni, and Sr were significantly and positively correlated with hypertension, while plasma titanium levels were negatively associated with hypertension development. These results suggest a complex interaction between various metals and the risk of hypertension in the elderly. Exposure to metal mixtures was positively associated with hypertension risk in elderly Chinese adults, with Ni, Cr, As, and V as key contributors. In addition, Zn, Ni, and Sr are significantly associated with an increased risk of hypertension, while Ti was positively associated with its development.