Hypertension incidence after tap-water implementation

A 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan

Shu Li Wang, Wan Fen Li, Chien Jen Chen, Yeou Lih Huang, Jein Wen Chen, Kuang Hsi Chang, Lih Yu Tsai, Kai Ming Chou

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Hypertension is the leading cause of cardiovascular disease worldwide. Long-term arsenic exposure has been linked to increased risk for hypertension; however, little is known whether a previous exposure has lingering effects on hypertension after the exposure being reduced significantly for decades. The study cohort was established in 1990 in an arseniasis-endemic area of 3 villages - Homei, Fuhsin, and Hsinming in Putai Township located on the southwestern coast of Taiwan, where residents were exposed to artesian well water (median level = 700 to 930μg/L) until early 1970s. The original cohort consisted of 490 non-hypertensive residents over 30-yrs-old and 352 of them were successfully followed up in 2002/03. Arsenic concentrations in the artesian well water consumed by residents during 1960s were used to indicate the previous exposure while urinary arsenic species measured in 2002/3 was used to represent current exposure. Hypertension incidences were 27.4, 65.6, and 69.1, per 1000. person-years for men aged 35-49, 50-64, and 65-74. years, respectively being higher than the corresponding rates of 25.1, 46.1, and 57.2 in a community-based longitudinal study. Cancer was the major cause of the total deaths (17/30 = 57%). Diastolic blood pressure was shown to increase with an increased cumulative arsenic ingestion from drinking water (β = 0.27, p<0.001). The incidence was increased by 2.43-fold in subjects of As(V) ≥ 2.67 μg/g creatinine as compared to those of As(V) < 1.20 μg/g creatinine (the third vs. first tertile; p=0.047) after adjustment for conventional risk factors. This study suggests that three decades after cessation of drinking artesian well water, residents of the endemic area are still at increased risk for developing hypertension, particularly those who excrete high amounts of As(V).

Original languageEnglish
Pages (from-to)4528-4535
Number of pages8
JournalScience of the Total Environment
Volume409
Issue number21
DOIs
StatePublished - Oct 1 2011

Fingerprint

hypertension
Arsenic
artesian well
arsenic
well water
Water
Creatinine
water
Blood pressure
Potable water
Drinking Water
cardiovascular disease
Coastal zones
drinking
risk factor
cancer
village
blood
drinking water
exposure

Keywords

  • Arsenic
  • Environmental health
  • Hypertension
  • Obesity
  • Risk assessment
  • Water consumption

ASJC Scopus subject areas

  • Environmental Chemistry
  • Pollution
  • Waste Management and Disposal
  • Environmental Engineering

Cite this

Hypertension incidence after tap-water implementation : A 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan. / Wang, Shu Li; Li, Wan Fen; Chen, Chien Jen; Huang, Yeou Lih; Chen, Jein Wen; Chang, Kuang Hsi; Tsai, Lih Yu; Chou, Kai Ming.

In: Science of the Total Environment, Vol. 409, No. 21, 01.10.2011, p. 4528-4535.

Research output: Contribution to journalArticle

Wang, Shu Li ; Li, Wan Fen ; Chen, Chien Jen ; Huang, Yeou Lih ; Chen, Jein Wen ; Chang, Kuang Hsi ; Tsai, Lih Yu ; Chou, Kai Ming. / Hypertension incidence after tap-water implementation : A 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan. In: Science of the Total Environment. 2011 ; Vol. 409, No. 21. pp. 4528-4535.
@article{74437dcef4b8475091dc5b28eb4304ea,
title = "Hypertension incidence after tap-water implementation: A 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan",
abstract = "Hypertension is the leading cause of cardiovascular disease worldwide. Long-term arsenic exposure has been linked to increased risk for hypertension; however, little is known whether a previous exposure has lingering effects on hypertension after the exposure being reduced significantly for decades. The study cohort was established in 1990 in an arseniasis-endemic area of 3 villages - Homei, Fuhsin, and Hsinming in Putai Township located on the southwestern coast of Taiwan, where residents were exposed to artesian well water (median level = 700 to 930μg/L) until early 1970s. The original cohort consisted of 490 non-hypertensive residents over 30-yrs-old and 352 of them were successfully followed up in 2002/03. Arsenic concentrations in the artesian well water consumed by residents during 1960s were used to indicate the previous exposure while urinary arsenic species measured in 2002/3 was used to represent current exposure. Hypertension incidences were 27.4, 65.6, and 69.1, per 1000. person-years for men aged 35-49, 50-64, and 65-74. years, respectively being higher than the corresponding rates of 25.1, 46.1, and 57.2 in a community-based longitudinal study. Cancer was the major cause of the total deaths (17/30 = 57{\%}). Diastolic blood pressure was shown to increase with an increased cumulative arsenic ingestion from drinking water (β = 0.27, p<0.001). The incidence was increased by 2.43-fold in subjects of As(V) ≥ 2.67 μg/g creatinine as compared to those of As(V) < 1.20 μg/g creatinine (the third vs. first tertile; p=0.047) after adjustment for conventional risk factors. This study suggests that three decades after cessation of drinking artesian well water, residents of the endemic area are still at increased risk for developing hypertension, particularly those who excrete high amounts of As(V).",
keywords = "Arsenic, Environmental health, Hypertension, Obesity, Risk assessment, Water consumption",
author = "Wang, {Shu Li} and Li, {Wan Fen} and Chen, {Chien Jen} and Huang, {Yeou Lih} and Chen, {Jein Wen} and Chang, {Kuang Hsi} and Tsai, {Lih Yu} and Chou, {Kai Ming}",
year = "2011",
month = "10",
day = "1",
doi = "10.1016/j.scitotenv.2011.07.058",
language = "English",
volume = "409",
pages = "4528--4535",
journal = "Science of the Total Environment",
issn = "0048-9697",
publisher = "Elsevier",
number = "21",

}

TY - JOUR

T1 - Hypertension incidence after tap-water implementation

T2 - A 13-year follow-up study in the arseniasis-endemic area of southwestern Taiwan

AU - Wang, Shu Li

AU - Li, Wan Fen

AU - Chen, Chien Jen

AU - Huang, Yeou Lih

AU - Chen, Jein Wen

AU - Chang, Kuang Hsi

AU - Tsai, Lih Yu

AU - Chou, Kai Ming

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Hypertension is the leading cause of cardiovascular disease worldwide. Long-term arsenic exposure has been linked to increased risk for hypertension; however, little is known whether a previous exposure has lingering effects on hypertension after the exposure being reduced significantly for decades. The study cohort was established in 1990 in an arseniasis-endemic area of 3 villages - Homei, Fuhsin, and Hsinming in Putai Township located on the southwestern coast of Taiwan, where residents were exposed to artesian well water (median level = 700 to 930μg/L) until early 1970s. The original cohort consisted of 490 non-hypertensive residents over 30-yrs-old and 352 of them were successfully followed up in 2002/03. Arsenic concentrations in the artesian well water consumed by residents during 1960s were used to indicate the previous exposure while urinary arsenic species measured in 2002/3 was used to represent current exposure. Hypertension incidences were 27.4, 65.6, and 69.1, per 1000. person-years for men aged 35-49, 50-64, and 65-74. years, respectively being higher than the corresponding rates of 25.1, 46.1, and 57.2 in a community-based longitudinal study. Cancer was the major cause of the total deaths (17/30 = 57%). Diastolic blood pressure was shown to increase with an increased cumulative arsenic ingestion from drinking water (β = 0.27, p<0.001). The incidence was increased by 2.43-fold in subjects of As(V) ≥ 2.67 μg/g creatinine as compared to those of As(V) < 1.20 μg/g creatinine (the third vs. first tertile; p=0.047) after adjustment for conventional risk factors. This study suggests that three decades after cessation of drinking artesian well water, residents of the endemic area are still at increased risk for developing hypertension, particularly those who excrete high amounts of As(V).

AB - Hypertension is the leading cause of cardiovascular disease worldwide. Long-term arsenic exposure has been linked to increased risk for hypertension; however, little is known whether a previous exposure has lingering effects on hypertension after the exposure being reduced significantly for decades. The study cohort was established in 1990 in an arseniasis-endemic area of 3 villages - Homei, Fuhsin, and Hsinming in Putai Township located on the southwestern coast of Taiwan, where residents were exposed to artesian well water (median level = 700 to 930μg/L) until early 1970s. The original cohort consisted of 490 non-hypertensive residents over 30-yrs-old and 352 of them were successfully followed up in 2002/03. Arsenic concentrations in the artesian well water consumed by residents during 1960s were used to indicate the previous exposure while urinary arsenic species measured in 2002/3 was used to represent current exposure. Hypertension incidences were 27.4, 65.6, and 69.1, per 1000. person-years for men aged 35-49, 50-64, and 65-74. years, respectively being higher than the corresponding rates of 25.1, 46.1, and 57.2 in a community-based longitudinal study. Cancer was the major cause of the total deaths (17/30 = 57%). Diastolic blood pressure was shown to increase with an increased cumulative arsenic ingestion from drinking water (β = 0.27, p<0.001). The incidence was increased by 2.43-fold in subjects of As(V) ≥ 2.67 μg/g creatinine as compared to those of As(V) < 1.20 μg/g creatinine (the third vs. first tertile; p=0.047) after adjustment for conventional risk factors. This study suggests that three decades after cessation of drinking artesian well water, residents of the endemic area are still at increased risk for developing hypertension, particularly those who excrete high amounts of As(V).

KW - Arsenic

KW - Environmental health

KW - Hypertension

KW - Obesity

KW - Risk assessment

KW - Water consumption

UR - http://www.scopus.com/inward/record.url?scp=80052522452&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052522452&partnerID=8YFLogxK

U2 - 10.1016/j.scitotenv.2011.07.058

DO - 10.1016/j.scitotenv.2011.07.058

M3 - Article

VL - 409

SP - 4528

EP - 4535

JO - Science of the Total Environment

JF - Science of the Total Environment

SN - 0048-9697

IS - 21

ER -