Background: The goal of this study is to assess how electrical conductivity (EC), an aggregate measure of all minerals in water, is associated with blood pressure in southwest coastal Bangladesh. Method: This analysis included 1,574 persons from 708 households participating in drinking water salinity reduction studies in southwest coastal Bangladesh in 2016-2017. We used multilevel regression models to estimate differences in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) across water salinity categories defined by the Food and Agricultural Organization of the United Nations: freshwater (electrical conductivity < 0.7 mS/cm), mild saline (EC > 0.7 and < 2 mS/cm), and moderately saline (EC > 2 and <10 mS/cm). EC was measured by Hanna SalinityTM meter. Models included participant-, household-, and community-level random intercepts and were adjusted for age, sex, body mass index, physical activity, smoking status, and household wealth. We also considered associations of EC with 24-hour urine biomarkers of Na, K, Ca and Mg intake using linear or parametric quantile regression models with the same adjustments and random effects. Missing data were handled by multiple imputations with chained equations. All results are reported with cluster-robust standard errors. Results: Drinkers of moderately saline water had 1.66 [95% confidence interval (CI): 0.1$33.19] mm Hg lower mean SBP and 1.30 [95% CI: 0.46, 2.13] mm Hg lower mean DBP compared to freshwater drinkers in adjusted models. Drinkers of moderately saline water had 17.50 [95% CI: 12.54, 22.45] mmol/day higher mean urinary Na, 0.32 [95% CI: -1.59, 2.23] mmol/day higher mean K, 1.24 [95% CI: 1.08, 1.41] times higher median daily urinary Ca, and 1.27 [95% CI: 1.10, 1.47] times higher median daily Mg compared to drinkers of fresh water in adjusted models. Conclusion: Higher drinking water salinity was associated with lower blood pressure, perhaps due to higher levels of salubrious minerals.
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机译：背景：本研究的目的是评估孟加拉国西南沿海地区的电导率（EC）（一种测量水中所有矿物质的总和）如何与血压相关联的方法。方法：该分析纳入了2016-2017年孟加拉国西南沿海地区708个家庭的1,574人参加的饮用水盐度降低研究。我们使用多级回归模型来估算联合国粮食及农业组织定义的水盐度类别之间的平均收缩压（SBP）和舒张压（DBP）的差异：淡水（电导率<0.7 mS / cm），轻度生理盐水（EC> 0.7和<2 mS / cm）和中度生理盐水（EC> 2和<10 mS / cm）。 EC通过Hanna SalinityTM仪进行测量。模型包括参与者，家庭和社区级别的随机拦截，并针对年龄，性别，体重指数，体育锻炼，吸烟状况和家庭财富进行了调整。我们还使用具有相同调整和随机效应的线性或参数分位数回归模型考虑了EC与24小时尿液中Na，K，Ca和Mg摄入的生物标志物的关联。丢失的数据通过链式方程的多次插补来处理。报告的所有结果均带有群集健壮的标准错误。结果：与调整模型中的淡水饮用者相比，中度盐水饮用者的平均SBP降低了1.66 [95％置信区间（CI）：0.1 $ 33.19] mm Hg，平均DBP降低了1.30 [95％CI：0.46，2.13] mm Hg。饮用中度盐水的人的平均尿钠含量高17.50 [95％CI：12.54，22.45] mmol /天，平均K值高0.32 [95％CI：-1.59，2.23] mmol /天，平均尿K，1.24 [95％CI：1.08，在调整后的模型中，每日饮用的钙中位数比饮用淡水的饮用者中位数高1.41倍，而每日Mg的中位数中位数是每日Mg的1.27 [95％CI：1.10，1.47]倍。结论：较高的饮用水盐度与较低的血压有关，这可能是由于矿物质含量较高所致。
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