Drinking water salinity and raised blood pressure: evidence from a cohort study in coastal Bangladesh

P. F. D. Scheelbeek, Muhammad A. H. Chowdhury, Andy Haines, Dewan S. Alam, Mo Hoque, Adrian P. Butler, Aneire E. Khan, Sontosh K. Mojumder, Marta A. G. Blangiardo, Paul Elliott, Paul Vineis

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Background – Millions of coastal inhabitants in South-east Asia have been experiencing increasing sodium concentrations in their drinking-water sources, likely to be partially due to climate change. High (dietary) sodium intake has convincingly been proven to increase risk of hypertension; it remains unknown, however, whether consumption of sodium in drinking water could have similar effects on health.

Objectives – We here present the results of a cohort-study in which we assessed the effects of drinking water sodium (DWS) on blood pressure (BP) in coastal populations in Bangladesh.

Methods – DWS, BP and information on personal, lifestyle and environmental factors were collected from 581 participants. We used generalised linear latent and mixed-methods to model effects of DWS on BP and assessed the associations between changes in DWS and BP when participants experienced changing water sodium levels and/or switched from “conventional” ponds or tube-wells to alternatives (Managed aquifer recharge [MAR] and rainwater harvesting) that aimed to reduce sodium levels.

Results – DWS-concentrations were highly associated with BP after adjustments for confounding factors. Furthermore, per 100mg/l lower sodium in drinking water, systolic/diastolic BP was lower on average by 0.95/0.57 mmHg and odds of hypertension lower by 14%. However, MAR did not consistently lower sodium levels.

Conclusions - DWS is an important source of daily sodium intake in salinity-affected areas, and a risk factor for hypertension. Considering the likely increasing trend in coastal salinity, prompt action is required. As MAR showed variable effects, alternative technologies for providing reliable, safe, low-sodium fresh-water should be developed alongside improvements in MAR and evaluated in ‘real-life’ salinity-affected settings.
Original languageEnglish
Article number057007
Pages (from-to)1-8
Number of pages8
JournalEnvironmental Health Perspectives
Issue number5
Publication statusPublished - 30 May 2017
Externally publishedYes


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