Key result
Mixed metal exposure is linked to higher blood pressure, mediated up to ~27% by oxidative stress.
Why the study?
The potential causal link between metal exposure and hypertension development remains uncertain, and studies on the interplay among metal exposure, hypertension, and oxidative stress are limited.
Does environmental exposure to single or mixed metals increase blood pressure in adults, and is this association mediated by oxidative stress?
Cross-Sectional (n=659)
No
Does environmental exposure to single or mixed metals increase blood pressure in adults, and is this association mediated by oxidative stress?
Effect estimate: Mediation rates of 19.09% for GSH and 27.36% for SOD
p-value: p=<0.05
Environmental exposure to combined heavy metals is associated with increased blood pressure, a relationship that appears partially mediated by alterations in oxidative stress.
Metal mixtures may elevate BP via oxidative stress; hypothesis-generating and leaves open causal confirmation in longitudinal studies.
Hypertension is a prevalent condition that contributes significantly to the global disease burden. Recent research endeavors have been investigating the potential causal link between metal exposure and the development of hypertension, yet consensus remains elusive. Nevertheless, studies examining the interplay among metal exposure, hypertension, and oxidative stress are relatively limited. This study utilized data from a cross-sectional survey conducted in southern Jiangxi Province, China. We evaluated urinary concentrations of 19 metals, including aluminum and manganese, in conjunction with measurements of systolic and diastolic blood pressures, as well as three oxidative stress biomarkers: glutathione peroxidase (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA). In the monometallic model, chromium, iron, manganese, and molybdenum exhibited positive correlations with blood pressure. These findings were consistent in the mixed exposure model. Conversely, all the aforementioned metals exhibited a negative correlation with GSH and SOD, while demonstrating a positive correlation with MDA. Mediation effect analysis revealed that GSH and SOD mediated the relationships between urinary concentrations of aluminum, iron, manganese, and antimony and blood pressure. In contrast, MDA mediated the associations between urinary silver and antimony and blood pressure. Furthermore, GSH and SOD were identified as mediators in part of the relationship between mixed metal exposure and blood pressure, with mediation rates of 19.09% for GSH and 27.36% for SOD. The results of this study suggest that exposure to both individual and combined metals effects blood pressure levels, which are further associated with changes in oxidative stress levels. Moreover, oxidative stress levels may modulate the changes in blood pressure related to metal exposure, providing a basis for further investigation into the health risks associated with these metal exposures.
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Huang et al. (2025) conducted a cross-sectional in Hypertension (n=659). Mixed metal exposure (urinary metals) vs. Lower levels of metal exposure was evaluated on Mediation of the relationship between mixed metal exposure and diastolic blood pressure by oxidative stress markers (Mediation rates of 19.09% for GSH and 27.36% for SOD, p=<0.05). Mixed environmental metal exposure was positively associated with blood pressure, and this relationship was partially mediated by alterations in oxidative stress markers, with mediation rates of 19.09% for GSH and 27.36% for SOD.
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