Abstract: TH-PO0266
Effects of Metal Mixtures on Blood Pressure and Hypertension in Afro-Caribbean Adults
Session Information
- Hypertension and CVD: Mechanisms
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1601 Hypertension and CVD: Basic
Authors
- Price, Natalie, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Jahan, Nusrat, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Cvejkus, Ryan, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Parsons, Patrick J, Wadsworth Center, Albany, New York, United States
- Gennings, Chris, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Barchowsky, Aaron, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Kuipers, Allison L, Michigan State University, Department of Epidemiology and Biostatistics, Lansing, Michigan, United States
- Wheeler, Victor W., Scarborough General Hospital, Lower Scarborough, Western Tobago, Trinidad and Tobago
- Zmuda, Joseph M., University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Sanders, Alison P., University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
- Miljkovic, Iva, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States
Background
Hypertension is a leading, modifiable risk factor for chronic kidney disease (CKD), a growing global health concern. While lifestyle and genetics play a role, environmental exposures, such as metal mixtures, may also elevate blood pressure and increase hypertension risk. Populations of African ancestry (PAA) face a disproportionate burden of hypertension, yet few studies have explored the role of metal mixtures among PAA. This study examined associations between urinary metal mixtures and blood pressure (BP) and hypertension (HTN) in middle-aged and older Afro-Caribbean adults. We hypothesized that metal mixture concentrations would be associated with higher BP and hypertensive status.
Methods
The Tobago Health Study is a population-based cohort of Afro-Caribbean adults. Our sample included 490 men and 445 women; all were included in HTN models, while only 314 men and 278 women not on antihypertensives were included in BP models. Urinary metal and metalloid concentrations were measured in 2014-2016 (men) and 2019-2020 (women), including arsenic (As), barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), copper (Cu), molybdenum (Mo), lead (Pb), tin (Sn), thallium (Tl), uranium (U) and zinc (Zn). Weighted quantile sum regression assessed associations between a mixture of metals and systolic (SBP), diastolic (DBP), pulse pressure (PP) and the odds of HTN. Covariates included age, education, BMI, smoking, alcohol, type 2 diabetes and urine creatinine.
Results
Among men, a one-unit increase in the metal mixture index was associated with 4.14 mmHg (95% CI: 0.47-7.81) higher SBP, 2.54 mmHg (95% CI: 0.50-4.58) higher PP and 38% (95% CI: 1-88%) higher odds of HTN. Co, Cu, Sn, Zn and Ba contributed to the association with SBP and PP, while Tl, Cd, Sn, Cs, Mo and Ba contributed to the higher odds of HTN. There were no significant metal mixture effects among women.
Conclusion
Environmental metal exposures were associated with elevated SBP, PP and odds of HTN in Afro-Caribbean men, independent of traditional risk factors. Elevated SBP and widened PP are linked to kidney disease progression. Further research is needed to understand the burden of kidney disease in this population and the role that elevated BP and metal mixtures play.
Funding
- NIDDK Support