Aug 2026· Ecotoxicology and Environmental Safety· Vol 323, pp.
120583
· 0 citations· 94 references
Medicine
TL;DR
The findings suggest that lead exhibits threshold-free linear toxicity, while manganese may have a protective effect, supporting preventive strategies for environmentally induced hypertension.
Abstract
This study systematically evaluates the association between trace metal exposure and hypertension risk, explores dose-response patterns, and investigates underlying molecular mechanisms. A systematic review was conducted according to PRISMA guidelines, including 39 high-quality observational studies retrieved from PubMed, Web of Science, Embase, and the Cochrane Library. Meta-analysis results showed a significant positive association between blood lead exposure and hypertension (OR = 1.16, 95% CI: 1.02-1.31) as well as gestational hypertension (OR = 1.56, 95% CI: 1.21-2.02). Conversely, blood manganese demonstrated a potential protective effect, showing a monotonically declining linear trend with hypertension risk and a significantly reduced risk of gestational hypertension (OR = 0.40, 95% CI: 0.25-0.65). Dose-response analysis based on restricted cubic splines revealed nonlinear patterns: blood cadmium exhibited a U-shaped dose-response relationship (P non-linear = 0.005) with risk rising markedly above 3.5 µg/L, and dietary zinc showed a J-shaped curve (P non-linear = 0.004) peaking around 22 mg/day. Urinary biomarkers (cadmium, lead, arsenic, zinc, vanadium, and cobalt) generally showed stronger associations with hypertension than blood biomarkers. However, for several metals - including vanadium, cobalt, chromium, and nickel - the available evidence was limited to one to three studies, and the corresponding risk estimates should therefore be interpreted with caution and require confirmation in future larger-scale studies. Bioinformatics analysis highlighted that trace metal exposure may promote hypertension through mechanisms such as oxidative stress, inflammatory responses (e.g., TNF signaling), and disruption of the AGE-RAGE pathway. The findings suggest that lead exhibits threshold-free linear toxicity, while manganese may have a protective effect. Pregnant women were identified as a particularly sensitive population to environmental metal exposure. This study provides epidemiological evidence and explores molecular mechanisms, supporting preventive strategies for environmentally induced hypertension. The image summary is shown in the Graphical Abstract.
This study demonstrates a significant positive association between blood lead levels and the risk of HU and no significant association is found between blood levels of cadmium, manganese, and mercury and the risk of HU.
Yanxia Gan, Xi Yu, Puhui Zhou· Joint Bone Spine· 0 citations
Background Uric acid is considered a potential risk factor for stroke; However, whether the association between hyperuricemia and stroke outcomes follows a linear or nonlinear pattern remains unclear. Therefore, this study conducted a dose–response meta-analysis based on cohort studies to investigate the association between hyperuricemia and stroke outcomes. Methods We systematically searched PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to April 2026. Cohort studies reporting the associations of uric acid with stroke incidence and mortality outcomes were included. Dose–response meta-analyses were performed by generalized least-squares estimation and restricted cubic splines with three knots located at the 10th, 50th, and 90th percentiles. Results A total of 25 cohort studies involving 1,300,263 participants were included. Conventional meta-analysis showed that hyperuricemia was significantly associated with stroke incidence (RR = 1.20, 95%CI: 1.11–1.29) and mortality (RR = 1.36, 95%CI: 1.17–1.58). Subgroup analysis indicated that hyperuricemia significantly increased the risks of stroke incidence (RR = 1.22, 95%CI: 1.08–1.38) and mortality (RR = 1.42, 95%CI: 1.15–1.77) among women. Regarding stroke subtype, hyperuricemia was significantly associated with the incidence (RR = 1.21, 95%CI: 1.03–1.42) and mortality (RR = 1.23, 95%CI: 1.01–1.49) of ischemic stroke. A J shaped dose–response relationship was found between uric acid and stroke incidence (p = 0.0023), with risk rising across uric acid levels from104 to 764.5 μmol/L and a nadir at 225 μmol/L, whereas no significant nonlinear relationship was observed for stroke mortality. Conclusion Hyperuricemia is associated with increased risks of stroke incidence and mortality, especially in women and ischemic stroke. A J-shaped dose–response relationship was observed for stroke incidence, but not for stroke mortality. Monitoring uric acid levels and their longitudinal changes may be valuable in stroke prevention strategies. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261394403, identifier PROSPERO (CRD420261394403).
Yue-Ning Liu, Jie Wang, Sai-Wei Bai et al.· Frontiers in Neurology· 0 citations
Evidence suggests a possible modest association between long-term PM2.5 exposure and VTE; however, considerable between-study variability and sensitivity to exposure harmonization limit definitive conclusions.
M. C. Correa Lara, J. G. Chávez, E. Hernández· Thrombosis and Haemostasis· 0 citations
This study indicates that higher dietary TAC intake is associated with a reduced risk of breast cancer, and well-designed longitudinal studies are warranted to confirm these findings.
Jianying Zhou, Hai-Yan Jin, Shan Jing et al.· Frontiers in Nutrition· 0 citations
Objective The association between habitual tea consumption and hypertension remains controversial. This systematic review and meta-analysis aimed to synthesize observational evidence on tea consumption and hypertension and to explore whether this association differed according to tea type, sex, age, region, and hypertension diagnostic threshold. Methods PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP were systematically searched from database inception to December 2025 for observational studies in adults. Studies reporting a distinct hypertension outcome and an extractable effect estimate for tea consumption were eligible. Study quality was assessed using the Newcastle–Ottawa Scale or AHRQ criteria, as appropriate. The most fully adjusted ORs, RRs, or HRs were extracted. Because these measures are not mathematically identical, pooled estimates were interpreted conservatively as relative association estimates rather than directly interchangeable causal effect measures. Dose–response analyses were conducted for studies with at least three quantitative exposure categories. Results Twenty studies involving 319,565 participants were included. In 16 cross-sectional studies, tea consumption was weakly associated with lower hypertension prevalence (OR = 0.92, 95% CI: 0.87–0.97, I2 = 62.8%). This inverse association was stronger for black tea drinkers, Asians, women, participants aged < 60 years, and studies with a hypertension cutoff of ≥140/90 mmHg; these subgroup results are hypothesis-generating, not confirmatory. Pooled ORs of the four cohort studies indicated a 13% lower hypertension risk (OR = 0.87, 95% CI: 0.84–0.92, I2 = 31.9%). Dose–response analysis suggested a significant nonlinear association, with an initially steeper inverse pattern at lower intake levels followed by an apparent plateau at higher reported intake. Conclusion Habitual tea consumption was associated with a modestly lower likelihood of hypertension in observational studies. Owing to the observational design and marked inter-study heterogeneity, a definite clinical protective effect cannot be confirmed. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, CRD420261288902.
Ren-Yu Jiang, Jin-Yan Chen, Hong-Li Lin et al.· Frontiers in Nutrition· 0 citations
The findings demonstrated a consistent association between NO₂ exposure and an increased risk of hypertension, particularly in poorly ventilated work environments, and underscore the importance of improving workplace air quality management, strengthening exposure monitoring, and implementing preventive occupational health strategies.
Ayudhia Rachmawati, Morrin Choirunnisa Thohira, M. Fitrah et al.· International Journal of Pub...· 0 citations
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