Exposure to certain essential elements, vitamins during pregnancy may improve midlife BP
Key takeaways:
- Copper, manganese and vitamin B12 during pregnancy were tied to reduced blood pressure at midlife.
- Elevated cesium and selenium levels were linked to increased BP, but the trend was not significant.
Levels of copper, manganese and vitamin B12 during pregnancy were associated with reduced blood pressure at midlife, according to new data.
There was a trend tying elevated levels of cesium and selenium with elevated BP, but the confidence intervals were wide, according to the study presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions and simultaneously published in Hypertension.
“The motivation for this study stems from our group’s interest in how environmental exposures impact cardiovascular (CV) health. Heavy metals such as lead, mercury and cadmium are among the top chemicals of public health concern, as recognized by the WHO, while essential elements such as manganese, selenium, and copper are beneficial for health at optimal levels. Previous studies have examined how metals affect BP and hypertension in the general population, and our prior research has examined how prenatal metal exposures affect children’s BP [Zhang M, et al. Environ Health Perspect. 2021;doi:10.1289/EHP8325],” Mingyu Zhang, PhD, MHS, epidemiologist and instructor in medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, told Healio. “There has been little research on how metal levels during pregnancy affect women’s long-term BP. Pregnancy induces physiological and behavioral changes that alter circulating metal and element levels in the body, and it is important to understand their long-term health effects.
“By studying the associations of pregnancy blood levels of metal and element with women’s midlife BP, we took a life course perspective — examining how exposures during pregnancy may shape CV health across decades,” Zhang told Healio.
Project Viva
Using data from Project Viva — which evaluated the impact of environmental and behavioral variables on the health of women who gave birth between 1999 and 2002 — Zhang and colleagues studied the association between levels of heavy metals and essential elements in red blood cells (RBC) as well as folate and vitamin B12 in plasma during pregnancy and midlife BP.
Heavy metals included arsenic, barium, cadmium, cesium, mercury and lead. Essential elements included copper, magnesium, manganese, selenium and zinc.
“Many essential elements and micronutrients, including vitamin B12, come from dietary sources and supplements, including prenatal vitamins. But it is important to note that our study did not directly assess the sources of these essential elements and vitamins — eg, are they from diet, supplements or other sources? Therefore, our results should not be interpreted as medical advice that women should change their intake during pregnancy,” Zhang told Healio. “Essential elements often function as a double-edged sword — both deficiencies and excessive levels may have negative health effects. In fact, 95% of our study participants had vitamin B12 levels within the normal range. This means we were not able to examine the effects of very high or very low levels on health outcomes.”
Pregnancy metals, elements, vitamins and midlife BP
The analysis included 493 women aged a median of 33 years at the time of enrollment who were around 51 years of age at midlife visit (72% white; median follow-up, 18.1 years).
Among metals and elements studied, a relationship emerged between copper and manganese levels during pregnancy and midlife risk for hypertension.
After adjustment, Zhang and colleagues reported that a doubling of RBC copper was associated with 25% reduced risk for midlife hypertension (RR = 0.75; 95% CI, 0.57-0.99) and a doubling of RBC manganese was associated with a 20% reduced risk for hypertension (RR = 0.8; 95% CI, 0.71-0.91).
Moreover, an association between plasma vitamin B12 and midlife BP also emerged.
The researchers reported that a doubling of vitamin B12 was associated with an average 3.64 mm Hg lower systolic BP (95% CI, 1.23-6.04) and an average 2.52 mm Hg lower diastolic BP (95% CI, 0.72-4.32).
“Many elements and micronutrients have antioxidant and anti-inflammatory properties and serve as key components for enzymatic functions in the human body. For example, copper plays a role in the copper-zinc superoxide dismutase, which helps protect against oxidative damage,” Zhang told Healio. “Additionally, copper is a cofactor for enzymes involved in the synthesis and stabilization of extracellular matrix components and angiogenesis, affecting factors like vascular endothelial growth factor that promote new blood vessel formation. Vitamin B12 is also an essential cofactor in metabolic processes. These are the ‘hypothesized’ mechanisms. This is an observational study, and we did not directly investigate the underlying biological mechanisms.
“The next step of this funded project is to better understand these mechanisms using proteomics data, which we are currently in the process of measuring using stored blood samples in Project Viva,” Zhang said. “Once we have the proteomics data, we hope to get a better understanding of the mechanistic pathways that underlie these associations.”
Reference:
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Zhang M, et al. Poster Presentation P3082. Presented at: Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions; March 6-9, 2025; New Orleans.
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