Abstract
Although antibiotic exposure in the general population has been well documented by a biomonitoring approach, epidemiologic data on the relationships between urinary antibiotic burden in the elderly with blood pressure (BP) are still lacking. The current study revealed thirty-four antibiotics in urine specimens from 990 elderly patients in Lu’an City, China, with detection frequencies ranging from 0.2 to 35.5%. Among the elderly, the prevalence of hypertension was 72.0%, and 12 antibiotics were detected in more than 10% of individuals with hypertension. The elderly with hypertension had the maximum daily exposure (5450.45 μg/kg/day) to fluoroquinolones (FQs). Multiple linear regression analyses revealed significant associations of BP and pulse pressure (PP) with exposure to specific antibiotics. The estimated β values (95% confidence interval) of associations with systolic blood pressure (SBP) in the right arm were 4.42 (1.15, 7.69) for FQs, 4.26 (0.52, 8.01) for the preferred as human antibiotics (PHAs), and 3.48 (0.20, 6.77) for the mixtures (FQs + tetracyclines [TCs] (tertile 3 vs. tertile 1)), respectively. Increased concentrations of TCs were associated with decreased diastolic BP (DBP; tertile 3: −1.75 [−3.39, −0.12]) for the right arm. Higher levels of FQs (tertile 3: 4.28 [1.02, 7.54]), PHAs (tertile 3: 4.25 [0.49, 8.01]), and FQs + TCs (tertile 3: 3.99 [0.71, 7.26]) were associated with increased SBP, and an increase in DBP for FQs (tertile 3: 1.82 [0.22, 3.42]) was shown in the left arm. Also, higher urinary concentrations of FQs (tertile 3: 3.18 [0.53, 5.82]), PHAs (tertile 3: 3.42 [0.40, 6.45]), and FQs + TCs (tertile 3: 3.06 [0.40, 5.72]) were related to increased PP, whereas a decline in PP for TCs (tertile 2: −2.93 [−5.60, −0.25]) in the right arm. And increased concentrations of penicillin V (tertile 3: 5.31 [1.53, 9.10]) and FQs + TCs (tertile 3: 2.84 [0.19, 5.49]) were related to higher PP in the left arm. By utilizing restricted cubic splines, our current study revealed a potential nonlinear dose-response association between FQ exposure and hypertension risk. In conclusion, this investigation is the first to present antibiotic exposure using a biomonitoring approach, and informs understanding of impacts of antibiotic residues, as emerging hazardous pollutants, on the hypertension risk in the elderly.
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Data availability
The datasets generated and analyzed during the current study are not publicly available due to the privacy of our research group, but are available from the corresponding author on reasonable request.
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Acknowledgements
We thank all the staff and students who made contributions to the cohort study. We thank all the study participants for their support. We are deeply grateful for the help provided by all the members (Guanjun Chen, Sheng Wang, and Shulong Li) in the Center for Scientific Research of Anhui Medical University.
Funding
This work was supported by the National Natural Science Foundation of China (82073558), Key Projects of Natural Science Research in Colleges and Universities of Anhui Province (KJ2018A0164), and Major Projects on College Leading Talent Team Introduced of Anhui (0303011224).
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Zhenkun Li: formal analysis, data curation, writing. Kaiyong Liu: investigation, conceptualization, methodology, supervision. Dongmei Zhang: investigation, methodology, supervision. Jianing Zhao: investigation, resources. Linsheng Yang: investigation, resources. Guimei Chen: investigation, resources. Annuo Liu: investigation, resources. Qunan Wang: investigation, resources. Sufang Wang: investigation, resources. Xiude Li: investigation, resources. Hongjuan Cao: investigation, resources. Fangbiao Tao: validation, conceptualization, supervision.
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Highlights
1. Antibiotics are widely distributed in the elderly with hypertension.
2. The elderly with hypertension had the maximum daily exposure (5450.45 μg/kg/day) to fluoroquinolones.
3. Some antibiotics were associated with decreased/increased blood pressure and pulse pressure in the elderly.
4. The elderly exposed to fluoroquinolones may increase the risk of hypertension.
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Li, Z., Liu, K., Zhao, J. et al. Antibiotics in elderly Chinese population and their relations with hypertension and pulse pressure. Environ Sci Pollut Res 29, 67026–67045 (2022). https://doi.org/10.1007/s11356-022-20613-3
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DOI: https://doi.org/10.1007/s11356-022-20613-3