Urinary Heavy Metals and Longitudinal Changes in Blood Pressure in Midlife Women: The Study of Women’s Health Across the Nation

Environmental exposure to heavy metals may contribute to increased blood pressure; however, evidence from midlife women who are at greater risk of cardio-metabolic disease is limited. We evaluated the associations of urinary concentrations of arsenic, cadmium, mercury, and lead with longitudinal changes in blood pressure in the Study of Women’s Health Across the Nation Multi-Pollutant Study. The sample included 1317 White, Black, Chinese, and Japanese women, aged 45 to 56 years at baseline (1999–2000), whose systolic blood pressure (SBP) and diastolic blood pressure were measured annually or biannually through 2017. Urinary metal concentrations were determined at baseline. Longitudinal changes in SBP and diastolic blood pressure were modeled using linear mixed-effects models by tertiles of metal concentrations. After multivariable adjustment, estimated annualized increases (95% CI) in SBP in the highest and lowest tertiles were 0.93 (0.85–1.01) mm Hg and 0.74 (0.66–0.82) mm Hg for arsenic, 0.82 (0.75–0.90) mm Hg and 0.72 (0.65–0.80) mm Hg for mercury, and 0.86 (0.78–0.93) mm Hg and 0.72 (0.64–0.79) mm Hg for lead, respectively. Similar results were observed for associations of arsenic, mercury, lead with diastolic blood pressure. Urinary cadmium was associated with a greater rate of increase in SBP only among never smokers. Women with higher concentrations of all four metals had greater annualized increases in SBP and diastolic blood pressure than those with lower concentrations. Our findings suggest that exposure to heavy metals may accelerate the increase in blood pressure in midlife women, supporting the need for continued efforts to reduce these environmental exposures.

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Urinary Heavy Metals and Longitudinal Changes in Blood Pressure in Midlife Women: the Study of Women’s Health Across the Nation

ISEE Conference Abstracts ◽

10.1289/isee.2021.p-054 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Xin Wang ◽

Carrie A. Karvonen Gutierrez ◽

William H. Herman ◽

Bhramar Mukherjee ◽

Sioban D. Harlow ◽

...

Keyword(s):

Heavy Metals ◽

Blood Pressure ◽

Women’S Health ◽

Women's Health ◽

Midlife Women ◽

Longitudinal Changes

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Biological Pathways of Long-Term Visit-to-Visit Blood Pressure Variability in the American Population: Cardiovascular Health Study and Women’s Health Initiatives

BioMed Research International ◽

10.1155/2020/3841945 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Mohammed F. Faramawi ◽

Mohammed S. Orloff ◽

Robert Delongchamp ◽

Yan Wang ◽

Eleanor Feingold ◽

...

Keyword(s):

Blood Pressure ◽

Women’S Health ◽

Women's Health ◽

Diastolic Blood Pressure ◽

Blood Pressure Variability ◽

Cardiovascular Health ◽

Biological Pathways ◽

Arterial Blood ◽

Health Initiatives

Studies reported a positive relationship between visit-to-visit blood pressure variability (VVBPV) and cardiovascular morbidity and mortality independently of the mean arterial blood pressure across clinical visits. The literature is scarce on the genes and biological mechanisms that regulate long-term VVBPV. We sought to identify biological pathways that regulate visit-to-visit blood pressure variability. We used phenotypic and genotype data from the Women’s Health Initiatives and Cardiovascular Health Studies. We defined VVBPV of systolic and diastolic blood pressure phenotypes as the standard deviation about the participant’s regression line with systolic and diastolic blood pressure regressed separately across visits. We imputed missing genotypes and then conducted a genome-wide association analysis to identify genomic variants related to the VVBPV and detect biological pathways. For systolic VVBPV, we identified a neurological pathway, the GABAergic pathway (P values = 1.1E − 2), and a vascular pathway, the RAP1 signaling pathway (P values = 5.8E − 2). For diastolic VVBPV, the hippo signaling (P values = 4.1E − 2), CDO myogenesis (P values = 7.0E − 2), and O-glycosylation of TSR domain-containing protein pathways (P values = 9.0E − 2) were the significant pathways. Future studies are warranted to validate these results. Further understanding of the roles of the genes regulating the identified pathways will help researchers to improve future pharmacological interventions to treat VVBPV in clinical practice.

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Sleep and risk for high blood pressure and hypertension in midlife women: the SWAN (Study of Women’s Health Across the Nation) Sleep Study

Sleep Medicine ◽

10.1016/j.sleep.2013.11.002 ◽

2014 ◽

Vol 15 (2) ◽

pp. 203-208 ◽

Cited By ~ 17

Author(s):

Karen A. Matthews ◽

Yuefang Chang ◽

Howard M. Kravitz ◽

Joyce T. Bromberger ◽

Jane F. Owens ◽

...

Keyword(s):

Blood Pressure ◽

Women’S Health ◽

Women's Health ◽

High Blood Pressure ◽

Midlife Women ◽

Sleep Study

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Urinary metals and incident diabetes in midlife women: Study of Women’s Health Across the Nation (SWAN)

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001233 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001233 ◽

Cited By ~ 2

Author(s):

Xin Wang ◽

Carrie A Karvonen-Gutierrez ◽

William H Herman ◽

Bhramar Mukherjee ◽

Siobán D Harlow ◽

...

Keyword(s):

Urinary Excretion ◽

Women’S Health ◽

Women's Health ◽

Midlife Women ◽

Incident Diabetes ◽

Japanese American ◽

Cobalt Chromium ◽

Metal Concentrations ◽

Metal Mixtures ◽

Exposure Patterns

IntroductionEnvironmental exposure to metals may play a role in the pathogenesis of diabetes; however, evidence from human studies is limited. We prospectively evaluated the associations of 20 urinary metal concentrations and their mixtures with incident diabetes in the Study of Women’s Health Across the Nation, a multisite, multiethnic cohort study of midlife women.Research design and methodsThe sample included 1237 white, black, Chinese and Japanese-American women, aged 45–56 years, free of diabetes at baseline (1999–2000) who were followed through 2016. Concentrations of 20 metals (arsenic, barium, beryllium, cadmium, cobalt, chromium, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, uranium, vanadium, tungsten and zinc) were measured in urine specimens at baseline. Incident diabetes was identified annually by fasting glucose ≥126 mg/dL, self-reported doctor-diagnosed diabetes, or self-reported use of antidiabetic medications. A non-parametric clustering method, k-means clustering, was used to identify subgroups with different exposure patterns to metal mixtures.ResultsAfter multivariable adjustment, the HR (95% CI) for diabetes associated with each doubling increase in urinary metal concentrations was 1.19 (1.10 to 1.30) for arsenic and 1.20 (1.05 to 1.37) for lead, in Cox proportional hazards models after controlling for multiple comparisons. A doubling in urinary excretion of zinc was associated with higher risk of diabetes (adjusted HR 1.31, 95% CI 1.11 to 1.53). Two distinct exposure patterns to metal mixtures—‘high’ versus ‘low’—were identified. Participants assigned to the ‘high’ pattern had higher overall concentrations of all metals compared with those classified into the ‘low’ pattern. Adjusted HR for diabetes associated with ‘high’ pattern compared with ‘low’ was 1.42 (1.08 to 1.87).ConclusionsHigher urinary concentrations of arsenic and lead, increased urinary excretion of zinc, as well as higher overall exposure to metal mixtures were associated with elevated risk of diabetes. Future studies should further investigate the underlying mechanisms.

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Urinary metals and metal mixtures and timing of natural menopause in midlife women: The Study of Women’s Health Across the Nation

Environment International ◽

10.1016/j.envint.2021.106781 ◽

2021 ◽

Vol 157 ◽

pp. 106781

Author(s):

Xin Wang ◽

Ning Ding ◽

Siobán D. Harlow ◽

John F. Randolph ◽

Bhramar Mukherjee ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Midlife Women ◽

Natural Menopause ◽

Metal Mixtures

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Results of the Women's Health Study of Accra: Assessment of blood pressure in urban women

International Journal of Cardiology ◽

10.1016/j.ijcard.2006.05.004 ◽

2007 ◽

Vol 117 (1) ◽

pp. 115-122 ◽

Cited By ~ 24

Author(s):

Rosemary B. Duda ◽

Min P. Kim ◽

Rudolph Darko ◽

Richard M.K. Adanu ◽

Joseph Seffah ◽

...

Keyword(s):

Blood Pressure ◽

Women’S Health ◽

Women's Health ◽

Urban Women ◽

Health Study

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The Rate of Increase in Blood Pressure in Children 5 Years of Age Is Related to Changes in Aerobic Fitness and Body Mass Index

PEDIATRICS ◽

10.1542/peds.94.4.465 ◽

1994 ◽

Vol 94 (4) ◽

pp. 465-470

Author(s):

Steven Shea ◽

Charles E. Basch ◽

Bernard Gutin ◽

Aryeh D. Stein ◽

Isobel R. Contento ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Body Mass ◽

Aerobic Fitness ◽

Medical Center ◽

Multiple Regression Model ◽

Age Related ◽

Rate Of Increase

Objective. To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children. Study design. Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19:7 months. Aerobic fitness was assessed using a treadmill All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study. Setting. An inner-city medical center. Outcome measures. Blood pressure was measured using an automated Dinamap device. Results. Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P < .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02) Conclusion. Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.

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Prevalent and Incident Vertebral Deformities in Midlife Women: Results from the Study of Women’s Health Across the Nation (SWAN)

PLoS ONE ◽

10.1371/journal.pone.0162664 ◽

2016 ◽

Vol 11 (9) ◽

pp. e0162664 ◽

Cited By ~ 5

Author(s):

Gail A. Greendale ◽

Holly Wilhalme ◽

Mei-Hua Huang ◽

Jane A. Cauley ◽

Arun S. Karlamangla

Keyword(s):

Women’S Health ◽

Women's Health ◽

Midlife Women ◽

Vertebral Deformities

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Women’s health in The BMJ: a data science history

BMJ Open ◽

10.1136/bmjopen-2020-039759 ◽

2020 ◽

Vol 10 (10) ◽

pp. e039759

Author(s):

Eva N Hamulyák ◽

Austin J Brockmeier ◽

Johanna D Killas ◽

Sophia Ananiadou ◽

Saskia Middeldorp ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Data Science ◽

Research Articles ◽

Research Article ◽

Rate Of Increase ◽

Medical Advances ◽

Over Time ◽

Health Programmes ◽

Specific Health

ObjectiveTo determine how the representation of women’s health has changed in clinical studies over the course of 70 years.DesignObservational study of 71 866 research articles published between 1948 and 2018 in The BMJ.Main outcome measuresThe incidence of women-specific health topics over time. General linear, additive and segmented regression models were used to estimate trends.ResultsOver 70 years, the overall odds that a word in a BMJ research article was ‘woman’ or ‘women’ increased by an annual factor of 1.023, but this rate of increase varied by clinical specialty with some showing little or no change. The odds that an article was about some aspect of women-specific health increased much more slowly, by an annual factor of 1.004. The incidence of articles about particular areas of women-specific medicine such as pregnancy did not show a general increase, but rather fluctuated over time. The incidence of articles making any mention of women, gender or sex declined between 1948 and 2005, after which it rose steeply so that by 2018 few papers made no mention of them at all.ConclusionsOver time women have become ever more prominent in BMJ research articles. However, the importance of women-specific health topics has waxed and waned as researchers responded ephemerally to medical advances, public health programmes, and sociolegal changes. The appointment of a woman editor-inchief in 2005 may have had a dramatic effect on whether women were mentioned in research articles.

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