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Meta-Analysis
. 2021 Aug;94(6):1137-1146.
doi: 10.1007/s00420-021-01714-x. Epub 2021 May 20.

Relationship of fluoride in drinking water with blood pressure and essential hypertension prevalence: a systematic review and meta-analysis

Mojtaba Davoudi  1   2 , Fateme Barjasteh-Askari  3   4   5 , Mohammad Sarmadi  3   4 , Mohammad Ghorbani  4   6 , Mehdi Yaseri  7 , Edris Bazrafshan  3   4 , Amir Hossein Mahvi  8   9 , Mohsen Moohebati  10   11
Affiliations
Meta-Analysis

Relationship of fluoride in drinking water with blood pressure and essential hypertension prevalence: a systematic review and meta-analysis

Mojtaba Davoudi et al. Int Arch Occup Environ Health. 2021 Aug.

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.

Keywords: Blood pressure; Drinking water; Fluoride; Hypertension.

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