Objective  To investigate the relationship between urinary metals and hypertension in residents for providing evidences to hypertension prevention and control in the residents.

  Methods  Using stratified multistage cluster sampling, we recruited 2 314 residents aged 18 years and above in regions along the Yangzi River in Anhui province and conducted questionnaire surveys, physical examination and laboratory detections among the residents from September 2014 to June 2015. Cadmium in urine samples collected from the residents was detected with graphite furnace atomic absorption spectrometry; while chromium, copper, iron, manganese, zinc, arsenic, and lead in the urine samples were detected with inductively coupled plasma emission spectrometer.

  Results  Of the residents surveyed, 1 073 (46.4%) were male and 1 241 (53.6%) were female; 1 609 were aged 18 – 59 years and 705 aged ≥ 60 years. Among the residents, totally 716 hypertension patients were identified and the hypertension prevalence rate was 30.94%. After creatinine correction, the contents of chromium, copper, iron, manganese, zinc and lead in urine samples of residents with hypertension were significantly higher than those in urine samples of residents without hypertension (all P < 0.05). The results of unconditional multivariate logistic regression analysis demonstrated that urinary iron was positively correlated with an increased hypertension risk (odds ratio OR = 1.448, 95% confidence interval 95% CI: 1.079 – 1.944); urinary cadmium and lead were also positively correlated with increased hypertension risk with the OR of 1.353 (95% CI: 1.022 – 1.792) and 1.659 (95% CI: 1.224 – 2.249), respectively.

  Conclusion  High urinary iron, cadmium and lead may predicate increased risk of hypertension among adult residents in regions along the Yangzi River in Anhui province.