Association of cumulative low-dose occupational ionizing radiation exposure with hypertension and blood pressure: a cross-sectional study of Chinese medical radiologists

OBJECTIVE: To evaluate the prevalence of hypertension and determine the dose-response relationship between cumulative occupational low-dose ionizing radiation (LDIR) exposure and blood pressure levels among medical radiologists in China. METHODS: A cross-sectional study was conducted among 5420 medical radiologists in Guangdong Province. Individual cumulative effective doses (CED) were reconstructed based on historical records (1980-2022). Blood pressure was assessed via standardized physical measurements rather than self-reporting. Hypertension was defined according to the 2017 ACC/AHA guidelines (SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg). Multivariable logistic and linear regression analyses were performed to assess associations, adjusting for demographic and lifestyle confounders. RESULTS: The overall prevalence of hypertension was 53.4%. After adjusting for confounders, cumulative effective dose was positively associated with hypertension risk. Compared with the reference group (<1.00 mSv), the adjusted odds ratios (ORs) for hypertension were 1.35 [95% confidence interval (95% CI) 1.06-1.70] for 5.00-9.99 mSv and 1.73 (95% CI 1.27-2.37) for at least 10.00 mSv. Linear regression confirmed that CED was positively associated with both SBP and DBP levels. Stratified analysis revealed gender-specific susceptibility: a significant risk increase was observed at least 5.00 mSv for men, whereas the threshold was at least 10.00 mSv for women. CONCLUSION: Cumulative occupational LDIR exposure is an independent risk factor for hypertension and elevated blood pressure among medical radiologists, exhibiting a clear dose-response relationship. The findings suggest gender-specific thresholds for vascular damage and advocate for enhanced cardiovascular surveillance in this high-risk population using stricter diagnostic criteria.