Drinking Water Salinity and Raised Blood Pressure: Evidence from a Cohort Study in Coastal Bangladesh.

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Title: Drinking Water Salinity and Raised Blood Pressure: Evidence from a Cohort Study in Coastal Bangladesh.
Author(s): Scheelbeek, P
Chowdhury, MAH
Haines, A
Alam, D
Hoque, MA
Butler, AP
Khan, AE
Mojumder, SK
Blangiardo, MAG
Elliott, P
Vineis, P
Item Type: Journal Article
Abstract: BACKGROUND: Millions of coastal inhabitants in Southeast Asia have been experiencing increasing sodium concentrations in their drinking-water sources, likely partially due to climate change. High (dietary) sodium intake has convincingly been proven to increase risk of hypertension; it remains unknown, however, whether consumption of sodium in drinking water could have similar effects on health. OBJECTIVES: We present the results of a cohort study in which we assessed the effects of drinking-water sodium (DWS) on blood pressure (BP) in coastal populations in Bangladesh. METHODS: DWS, BP, and information on personal, lifestyle, and environmental factors were collected from 581 participants. We used generalized linear latent and mixed methods to model the effects of DWS on BP and assessed the associations between changes in DWS and BP when participants experienced changing sodium levels in water, switched from "conventional" ponds or tube wells to alternatives [managed aquifer recharge (MAR) and rainwater harvesting] that aimed to reduce sodium levels, or experienced a combination of these changes. RESULTS: DWS concentrations were highly associated with BP after adjustments for confounding factors. Furthermore, for each 100 mg/L reduction in sodium in drinking water, systolic/diastolic BP was lower on average by 0.95/0.57 mmHg, and odds of hypertension were lower by 14%. However, MAR did not consistently lower sodium levels. CONCLUSIONS: DWS is an important source of daily sodium intake in salinity-affected areas and is a risk factor for hypertension. Considering the likely increasing trend in coastal salinity, prompt action is required. Because MAR showed variable effects, alternative technologies for providing reliable, safe, low-sodium fresh water should be developed alongside improvements in MAR and evaluated in "real-life" salinity-affected settings. https://doi.org/10.1289/EHP659.
Publication Date: 30-May-2017
Date of Acceptance: 31-Aug-2016
URI: http://hdl.handle.net/10044/1/51545
DOI: https://dx.doi.org/10.1289/EHP659
ISSN: 0091-6765
Publisher: The National Institute of Environmental Health Sciences (NIEHS)
Journal / Book Title: Environmental Health Perspectives
Volume: 125
Issue: 5
Copyright Statement: Reproduced with permission from Environmental Health Perspectives. Content is in the Public Domain
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 097816/Z/11/B
Keywords: Adult
Bangladesh
Blood Pressure
Climate Change
Cohort Studies
Drinking Water
Female
Groundwater
Humans
Hypertension
Middle Aged
Salinity
Sodium
Water Supply
Humans
Hypertension
Sodium
Cohort Studies
Water Supply
Blood Pressure
Adult
Middle Aged
Bangladesh
Female
Salinity
Climate Change
Groundwater
Drinking Water
Adult
Bangladesh
Blood Pressure
Climate Change
Cohort Studies
Drinking Water
Female
Groundwater
Humans
Hypertension
Middle Aged
Salinity
Sodium
Water Supply
11 Medical And Health Sciences
05 Environmental Sciences
Toxicology
Publication Status: Published online
Article Number: 057007
Open Access location: https://ehp.niehs.nih.gov/wp-content/uploads/2017/05/EHP659.alt_.pdf
Appears in Collections:Civil and Environmental Engineering
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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