Relationship of Fluoride in Drinking Water With Blood Pressure and Essential Hypertension Prevalence: A Systematic Review and Meta-Analysis Publisher Pubmed



Davoudi M^{1, 2} ; Barjastehaskari F^{3, 4, 5} ; Sarmadi M^{3, 4} ; Ghorbani M^{4, 6} ; Yaseri M⁷ ; Bazrafshan E^{3, 4} ; Mahvi AH^{5, 8} ; Moohebati M^{9, 10} Show Affiliations
Source: International Archives of Occupational and Environmental Health Published:2021

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. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.