Association analysis of radiation exposure and the risk of hypertension and analysis of mediating role

Abstract Background The aim of this study was to investigate the impact of radiation exposure on hypertension in radiation workers and explore the mediating role of blood lipids. Methods This cross-sectional study collected the demographic characteristics and occupational features of 2,062 radiation workers recorded during a physical examination at a hospital in Shijiazhuang City between 2021 and 2024. A logistic regression model and a subgroup analysis were used to explore the association between radiation exposure and hypertension. Restricted cuboid plots were used to analyse the nonlinear association between length of service and hypertension, and a mediation analysis was performed to explore the mediating role of blood lipids. Results Among 2,062 radiation workers, 427 (20.71%) had hypertension. Length of service, length of service grouping, type of physical examination, and exposure group were positively correlated with hypertension. In terms of job classification, compared with the industrial group, the medical radiology group was negatively correlated with hypertension (all P < 0.05). The subgroup analysis revealed that except for job type, which was negatively associated with hypertension men who were aged 35 years or older, had a lower education level, drank alcohol, and were overweight, the rest of the radiation exposures were positively associated with hypertension (all P < 0.05). The restricted cubic sample model revealed a linear correlation between length of service and hypertension. The mediation analysis revealed that increased levels of TC and LDL-C mediated the association between length of service group and hypertension in 11.3% (P < 0.05) and 11.9% of patients (P < 0.05), respectively, and that decreased levels of HDL-C mediated the association between type of work and hypertension in 2.5% of patients. Conclusions Our results indicate that radiation exposure increases the risk of hypertension, particularly in men who are aged 35 years or older, have a lower education level, drink alcohol, and are overweight. Both TC and LDL-C mediate the association between length of service grouping and hypertension, whereas HDL-C mediates the association between job classification and hypertension.