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Relationship of fluoride in drinking water with blood pressure and essential hypertension prevalence: a systematic review and meta-analysis.
| International Archives of Occupational and Environmental Health | Davoudi M, Barjasteh-Askari F, Sarmadi M, Ghorbani M, Yaseri M, Bazrafshan E, Mahvi AH, Moohebati M. | [Epub ahead of print]
Endemic fluorosis areas Systematic review Blood Pressure Heart Review
Data availability The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. References Aghaei M, Derakhshani R, Raoof M, Dehghani M, Mahvi AH (2015a) Effect of fluoride in drinking water on birth height and weight: an ecological study in Kerman Province Zarand County, Iran. Fluoride 48:160–168 CAS  Google Scholar Aghaei M, Karimzade S, Yaseri M, Khorsandi H, Zolfi E, Mahvi

Abstract

Background and objective

Previous studies showed controversial results of the relationship between fluoride exposure through drinking water and elevated blood pressure. We conducted a systematic review and meta-analysis to assess the direct relationship of drinking water fluoride exposure with blood pressure and essential hypertension prevalence in general populations.

Methods

We conducted a systematic search in databases including Web of Knowledge, PubMed, Scopus, and Embase by MeSH and non-MeSH terms for relevant studies with any design published until August 2019, with no limitation in time and language. The pooled effect measure was calculated within a 95% confidence interval (CI).

Results

Our search retrieved 630 journal articles, six of which were eligible for data extraction. The random-effects model found significantly higher systolic blood pressure (mean difference = 6.49 mmHg; 95% CI 3.73–9.25; p value < 0.01) and diastolic blood pressure (mean difference = 4.33 mmHg; 95% CI 1.39–7.26; p value < 0.01) in groups exposed to high-fluoride drinking water than in groups exposed to normal/low-fluoride drinking water. A significant relationship was also found between high-fluoride drinking water and essential hypertension (odds ratio = 2.14; 95% CI 1.02–4.49; p value = 0.045).

Conclusion

The risk of elevated blood pressure increases in the general population of fluoride endemic areas. However, more research is needed to make a firm conclusion about the adverse effects of excess fluoride intake on the cardiovascular system at the individual level.

*Original abstract online at https://link.springer.com/article/10.1007%2Fs00420-021-01714-x

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The financial Grant from the Research Deputy of Tehran University of Medical Sciences, Tehran, Iran, with code 43155 on this research study.

Author information

Affiliations

  1. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Mojtaba Davoudi

  2. Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

    Mojtaba Davoudi

  3. Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Fateme Barjasteh-Askari, Mohammad Sarmadi & Edris Bazrafshan

  4. Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Fateme Barjasteh-Askari, Mohammad Sarmadi, Mohammad Ghorbani & Edris Bazrafshan

  5. Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, PourSina St., Enghelab St., Tehran, 1417613151, Iran

    Fateme Barjasteh-Askari & Amir Hossein Mahvi

  6. Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Mohammad Ghorbani

  7. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

  8. Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran

    Amir Hossein Mahvi

  9. Atherosclerosis Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Mohsen Moohebati

  10. Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Mohsen Moohebati

Contributions

MD and AHM contributed to the concept and design of the study. MS, MD, and FBA conducted the initial search, extracted the data, and drafted the manuscript. MGH, FBA, and MY performed data analysis and interpretation. AHM, EB, and MM read the manuscript and revised it for important intellectual content. All the authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Amir Hossein Mahvi.

*Original abstract online at https://link.springer.com/article/10.1007%2Fs00420-021-01714-x