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The authors studied the effects of environmental cadmium exposure on blood pressure (BP). Subjects 1,140 men and 1,713 women, aged ≥ 50 yr lived in three areas of Japan considered "unpolluted" by cadmium. Multiple logistic regression analysis was used to evaluate relationships between hypertension/nonhypertension and cadmium concentrations in blood (B-Cd) or urine (U-Cd). Age, body mass index, drinking and smoking habits, and blood and urine chemistry data were incorporated into the model. Odds ratios for hypertension were significantly less than 1 in either gender when U-Cd was the indicator of cadmium exposure and hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg. The results suggest a significant negative association between cadmium exposure and BP in inhabitants in Japan.