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Drinking Water Salinity, Urinary Macro-Mineral Excretions, and Blood Pressure in the Southwest Coastal Population of Bangladesh

Naser, AM; Rahman, M; Unicomb, L; Doza, S; Gazi, MS; Alam, GR; Karim, MR; ... Clasen, TF; + view all (2019) Drinking Water Salinity, Urinary Macro-Mineral Excretions, and Blood Pressure in the Southwest Coastal Population of Bangladesh. Journal of the American Heart Association , 8 (9) , Article e012007. 10.1161/JAHA.119.012007. Green open access

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Abstract

Background Sodium (Na+) in saline water may increase blood pressure (BP), but potassium (K+), calcium (Ca2+), and magnesium (Mg2+) may lower BP. We assessed the association between drinking water salinity and population BP. Methods and Results We pooled 6487 BP measurements from 2 cohorts in coastal Bangladesh. We used multilevel linear models to estimate BP differences across water salinity categories: fresh water (electrical conductivity, <0.7 mS/cm), mild salinity (electrical conductivity ≥0.7 and <2 mS/cm), and moderate salinity (electrical conductivity ≥2 and <10 mS/cm). We assessed whether salinity categories were associated with hypertension using multilevel multinomial logistic models. Models included participant‐, household‐, and community‐level random intercepts. Models were adjusted for age, sex, body mass index (BMI), physical activity, smoking, household wealth, alcohol consumption, sleep hours, religion, and salt consumption. We evaluated the 24‐hour urinary minerals across salinity categories, and the associations between urinary minerals and BP using multilevel linear models. Compared with fresh water drinkers, mild‐salinity water drinkers had lower mean systolic BP (−1.55 [95% CI: −3.22–0.12] mm Hg) and lower mean diastolic BP (−1.26 [95% CI: −2.21–−0.32] mm Hg) adjusted models. The adjusted odds ratio among mild‐salinity water drinkers for stage 1 hypertension was 0.60 (95% CI: 0.43–0.84) and for stage 2 hypertension was 0.56 (95% CI: 0.46–0.89). Mild‐salinity water drinkers had high urinary Ca2+, and Mg2+, and both urinary Ca2+ and Mg2+ were associated with lower BP. Conclusions Drinking mild‐salinity water was associated with lower BP, which can be explained by higher intake of Ca2+ and Mg2+ through saline water.

Type: Article
Title: Drinking Water Salinity, Urinary Macro-Mineral Excretions, and Blood Pressure in the Southwest Coastal Population of Bangladesh
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/JAHA.119.012007
Publisher version: https://doi.org/10.1161/JAHA.119.012007
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Keywords: blood pressure, calcium, drinking water salinity, magnesium, potassium, sodium, water salinity
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Inst for Risk and Disaster Reduction
URI: https://discovery.ucl.ac.uk/id/eprint/10074547
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