O-92 The effects of metal mixtures on blood pressure and hypertension in adults from Tobago
Author(s):
NF Price, N Jahan , R Cvejkus , PJ Parsons, EJ Mullin , C Gennings , A Barchowsky , AL Kuipers , V Wheeler , J Zmuda, AP Sanders, I Miljkovic
Year of Presentation:
2026
Objective: This study evaluated associations of urinary
metal mixtures with blood pressure (BP) and hypertension (HTN) in middle-aged and older Tobagonian adults.
We hypothesized that higher metal mixture concentrations
would be associated with higher BP and greater odds of
HTN.
Methods: We included a random sample from the Tobago Health Study, a population-based cohort of Tobagonian adults. Spot urine samples collected in 2014–2016 (men, n=487) and 2019–2020 (women, n=406) were analyzed for a panel of metal(loid)s 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). Linear, logistic and weighted quantile sum regression were applied to assess associations of individual metals and their mixtures with systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP) and the odds of HTN. Models were stratified by sex due to differences in timing of urine sample collection. Covariates included age, education, BMI, smoking, alcohol use, type 2 diabetes, sedentary behavior, sleep duration, antihypertensive use (BP models only), and urine creatinine. Holm’s method was used to adjust for multiple comparisons.
Results: In individual metal analyses among men, a onequintile increase in Cu was associated with higher SBP (3.54 mmHg, 95% CI: 1.81–5.26), DBP (1.79 mmHg, 95% CI: 0.85–2.73), and PP (1.75 mmHg, 95% CI: 0.57–2.94). Among men, a one-quintile increase in metal mixture was associated with higher SBP (4.06 mmHg, 95% CI: 0.27– 3.99) and DBP (2.12 mmHg, 95% CI: 0.27–3.99), primarily driven by Cu, with possible contributions by Co, Ba, and As. No individual metals or mixtures were significantly associated with HTN, nor any BP or HTN outcomes among women
Conclusion: Higher urinary Cu concentrations were associated with higher BP and PP among men. More research is needed to understand the observed sex differences.