Associations Between Copper and Zinc and High Blood Pressure in Children and Adolescents Aged 8–17 Years: an Exposure-Response Analysis of NHANES 2007–2016

Several studies have indicated an association between dietary copper and zinc intake and hypertension, but mainly limited to adult studies. Few studies have examined the associations between copper and zinc and high blood pressure (BP) in children. This study aims to evaluate the associations of zinc and copper with the risk of high BP in children and adolescents aged 8–17 years using the 2007–2016 National Health and Nutritional Examination Surveys (NHANES). A total of 7749 participants (3912 males and 3837 females) were included in the analyses. High BP was defined as (1) the participant (age ≥ 16 years) or the participant’s parent/guardian (age < 16 years) reported that the participant had a diagnosis of hypertension irrespective of the BP value; or (2) the participant (age ≥ 16 years) or the participant’s parent/guardian (age < 16 years) reported that the participant was currently taking an antihypertensive medication irrespective of the BP value; or (3) a participant classified as having elevated BP /hypertension according to the American Academy of Pediatrics (AAP) new guidelines. Zinc and copper intakes from diet and supplements were assessed with 24-h dietary recall. Positive correlation was found between copper intake and high BP for females, and the ORs (95% CI) across quartiles 2 to 4 compared with quartile 1 were 1.28 (0.81–2.03), 2.06 (1.26–3.36), and 2.69 (1.45–4.98) after adjusting age, gender, race/ethnicity, body mass index (BMI), serum cotinine levels, annual family income, total daily energy intake, and intakes of calcium, sodium, and potassium. Negative correlation was found for males, and the multivariate-adjusted ORs (95% CI) across quartiles 2 to 4 compared with quartile 1 were 0.81 (0.57–1.14), 0.63 (0.42–0.92), and 0.60 (0.37–1.00), respectively. A statistically significantly OR (95% CI) [1.70 (1.08–2.67)] between zinc intake and high BP was observed for participants with normal weight comparing quartiles 3 to quartile 1 of dietary zinc intake. This study suggests that dietary copper and zinc intake may affect BP in children and adolescents. Further longitudinal studies should be warranted to confirm these findings.