Changes in blood pressure during pregnancy associated with drinking water arsenic exposure in inner Mongolia, China, 1997 to 1999 (original) (raw)

2004, Annals of Epidemiology

PURPOSE: To examine the relationship between adult or adolescent sexual abuse (ASA) and erectile dysfunction (ED). METHODS: The analyses were conducted using preliminary data from the Boston Area Community Health Survey (BACH), a population-based random sample survey of Hispanic, non-Hispanic African American, and non-Hispanic Caucasian men aged 30 to 79 years of age residing in Boston, MA. We conducted multiple logistic regression analyses in our sample of 741 men with complete data on ED and ASA. We used complex sampling strategies with stratification and multiple stages; therefore, the data were weighted to account for the unequal probability of subject selection. Weighted and unweighted data were analyzed in this study. ED and ASA were each operationalized using a selfadministered questionnaire. The presence of ED was determined based on the subjects response to a question related to impotence, where a response of ''Not impotent'' was scored as no ED and ''minimally'', ''moderately,'' and ''completely impotent'' responses were scored as ED present. The presence of ASA was determined based on the subjects responses to questions related to sexual abuse occurring at age 14 or older. RESULTS: Our sample included 262 men with ED and 479 without ED. In addition, 99 men experienced ASA with 642 men having no such experience. In the unweighted analyses, the multiple logistic regression model, controlling for race and age, ASA (odds ratio OR Z 1.65, 95% confidence interval CI Z 1.10, 2.60) was positively associated with ED. We hypothesized that depression was a mediator here; however, adding depression to the model had only a minor influence on the odds ratio for ASA (OR Z 1.59, 95% CI Z 1.01, 2.50). The weighted analyses yielded similar results. The multiple logistic regression model, controlling for race and age, yielded ASA OR Z 1.75 (95% CI Z 0.83, 3.69). The weighted data including depression in the model yielded ASA OR Z 1.55 (95% CI Z 0.78, 3.08). CONCLUSION: Men who have experienced sexual abuse as adolescents or adults appear to experience more erectile dysfunction than other men. 2 currently at RTI International, Research Triangle Park, NC PURPOSE: Previous studies have reported an association between chronic exposure to elevated levels of drinking water arsenic and cardiovascular and other health effects. There is debate, however, whether human health effects exist at lower exposure levels. Prior studies have been unable to investigate these potential health effects due to imprecise exposure estimation. Examining a sensitive subpopulation such as pregnant women proves more efficient in detecting potential health effects associated with drinking water arsenic. METHODS: A population-based cohort study was conducted based on the prenatal care visits of 5306 women in Inner Mongolia, China, from 1997 to 1999. Repeated measures mixed models were used to assess associations between drinking water arsenic estimates and serial blood pressure measurements taken during prenatal care visits. RESULTS: Once selected confounders were controlled for, exposure to drinking water arsenic was positively associated with mean arterial blood pressure, even at lower ranges of exposure. Arsenic exposure categories of 51 to 100 mg/L and more than 100 mg/L were associated with increases in mean arterial pressure of 3.56 (95% CI Z 1.66, 5.47) and 2.30 (0.57, 4.02) mmHg, respectively, relative to the mean arterial pressure of women exposed to drinking water arsenic concentrations ranging from below detectable levels to 20 mg/L. These changes were not consistent over the course of gestation and became somewhat less pronounced later in pregnancy. CONCLUSION: Mean arterial pressure during pregnancy is associated with exposure to drinking water arsenic among otherwise healthy pregnant women, suggesting a potential vascular effect of drinking water arsenic at lower doses than had been previously reported.