Metal mixture mediates associations between socioeconomic indicators and blood pressure outcomes in rural Bangladeshi adults: Evidence from a prospective population study
Year: 2022
Type: conference-abstract
Abstract: BACKGROUND AND AIM: There is limited evidence on the causal mechanism in the socioeconomic differentials in blood pressure (BP) in low and middle-income countries (LMICs). We, therefore, examined the associations of socioeconomic indicators (SEIs) and BP, socioeconomic disparities in metal mixture exposures, and the potential mediation effect of metal mixtures in the associations between SEIs and BP outcomes in rural Bangladeshi adults. METHODS: This study included 900 rural Bangladeshi adults prospectively followed for six years in the Bangladesh vitamin E and selenium Trial (BEST). Blood pressure was measured at baseline and during three biennial follow-up examinations. Blood levels of arsenic, lead, selenium, and urinary arsenic, including socioeconomic indicators-years of education, and agricultural land ownership (ALO), were measured at baseline. Weighted quantile sum (WQS) regression was used to estimate the joint effects of metal mixture on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) taken at the third follow-up. Causal mediation effect of the metal mixture was estimated using the parametric g-computation method. RESULTS: Education was positively, but ALO was inversely associated with BP. Participants with higher SEIs were less likely to be exposed to metal mixtures than their counterparts. Metal mixture mediated the associations of SEIs with SBP, DBP, MAP, and PP. For example, the randomized analogue of total natural direct effect (rRTNDE) was 5.31 (95% CI: 1.91, 8.77) and the pure natural indirect effect (rRPNIE) was -0.67 (95% CI: -1.34, -0.22) for education and SBP. Similarly, the rRTNDE was -2.31 (95% CI: -4.37, -0.33) and the rRPNIE was -0.29 (95% CI: -0.70, -0.03) for ALO and SBP. There was no evidence of the exposure-mediator interaction in the mediation models (Pint>0.20). CONCLUSIONS: Our study suggests that metal mixture mediates socioeconomic differentials in BP. KEYWORDS: Blood Pressure; Metals; SES; Mediation; Mixture
Source: ISEE Conference Abstracts
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W4320065700