Association of low-level blood lead and blood pressure in NHANES 1999-2006.

This study investigated whether low blood-lead levels (≤10 μg/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and logistic regressions stratified by race/ethnicity and gender were performed. Blood lead levels (BLL) were significantly correlated with higher systolic BP among black men and women, but not white or Mexican-American participants. BLLs were significantly associated with higher diastolic BPs among white men and women and black men, whereas, a negative association was observed in Mexican-American men that had, also, a wider pulse pressure. Black men in the 90th percentile of blood lead distribution (BLL≥3.50 μg/dL) compared to black men in the 10th percentile of blood lead distribution (BLL≤0.7 μg/dL) had a significant increase of risk of having hypertension (adjusted POR=2.69; 95% CI: 1.08-6.72). In addition, blood cadmium was significantly associated with hypertension and systolic and diastolic blood. This study found that, despite the continuous decline in blood lead in the U.S. population, lead exposure disparities among race and gender still exist.

[1]  T. Glass,et al.  Association of blood lead and tibia lead with blood pressure and hypertension in a community sample of older adults. , 2006, American journal of epidemiology.

[2]  K. Liang,et al.  Increased nitric oxide inactivation by reactive oxygen species in lead-induced hypertension. , 1999, Kidney international.

[3]  Jiang He,et al.  Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. , 2002, JAMA.

[4]  Ellen K Silbergeld,et al.  Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults. , 2006, Circulation.

[5]  S. Rothenberg,et al.  Blood lead level and blood pressure during pregnancy in South Central Los Angeles. , 1999, Archives of environmental health.

[6]  Ellen K. Silbergeld,et al.  Blood Lead Below 0.48 &mgr;mol/L (10 &mgr;g/dL) and Mortality Among US Adults , 2006 .

[7]  R. Canfield,et al.  Intellectual Impairment in Children with Blood Lead Concentrations below 10 μg per Deciliter , 2003 .

[8]  Ellen K Silbergeld,et al.  Blood lead, blood pressure, and hypertension in perimenopausal and postmenopausal women. , 2003, JAMA.

[9]  Pam Tucker,et al.  Draft toxicological profile for cadmium , 2008 .

[10]  Elisabete Pinto Blood pressure and ageing , 2007, Postgraduate Medical Journal.

[11]  E. Guallar,et al.  Lead Exposure and Cardiovascular Disease—A Systematic Review , 2006, Environmental health perspectives.

[12]  K. Flegal,et al.  The decline in blood lead levels in the United States. The National Health and Nutrition Examination Surveys (NHANES) , 1994, JAMA.

[13]  Brian S. Schwartz,et al.  The Epidemiology of Lead Toxicity in Adults: Measuring Dose and Consideration of Other Methodologic Issues , 2006, Environmental health perspectives.

[14]  D. Paek,et al.  Cadmium in blood and hypertension. , 2008, The Science of the total environment.

[15]  David E. Jacobs,et al.  Exposure of U.S. Children to Residential Dust Lead, 1999–2004: I. Housing and Demographic Factors , 2008, Environmental health perspectives.

[16]  C. Crainiceanu,et al.  Cadmium Exposure and Hypertension in the 1999–2004 National Health and Nutrition Examination Survey (NHANES) , 2007, Environmental health perspectives.

[17]  A. Michelakis,et al.  Lead intoxication: its effect on the renin-aldosterone response to sodium deprivation. , 1970, Archives of environmental health.

[18]  V. Preedy,et al.  National Health and Nutrition Examination Survey , 2010 .

[19]  N. Vaziri,et al.  Lead promotes hydroxyl radical generation and lipid peroxidation in cultured aortic endothelial cells. , 2000, American journal of hypertension.

[20]  D. Levy,et al.  Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. , 1997, Circulation.

[21]  E W Gunter,et al.  Exposure of the U.S. population to lead, 1991-1994. , 1998, Environmental health perspectives.

[22]  P. Muntner,et al.  Continued decline in blood lead levels among adults in the United States: the National Health and Nutrition Examination Surveys. , 2005, Archives of internal medicine.

[23]  Herbert L. Needleman,et al.  Preventing lead poisoning in young children , 1978 .

[24]  J. Coresh,et al.  Blood lead and chronic kidney disease in the general United States population: results from NHANES III. , 2003, Kidney international.

[25]  Brian S. Schwartz,et al.  Recommendations for Medical Management of Adult Lead Exposure , 2006, Environmental health perspectives.

[26]  J R Landis,et al.  The relationship between blood lead levels and blood pressure and its cardiovascular risk implications. , 1985, American journal of epidemiology.

[27]  Annette Ashizawa,et al.  Toxicological Profile for Lead , 2007 .

[28]  A. Michelakis,et al.  Plasma renin activity in chronic plumbism. Effect of treatment. , 1971, Archives of internal medicine.

[29]  J. Staessen,et al.  The relationship between blood pressure and blood lead in NHANES III , 2002, Journal of Human Hypertension.

[30]  Bruce A. Fowler,et al.  Modification by ALAD of the Association between Blood Lead and Blood Pressure in the U.S. Population: Results from the Third National Health and Nutrition Examination Survey , 2009, Environmental health perspectives.

[31]  P. Lijnen,et al.  Urinary kallikrein activity in workers exposed to cadmium, lead, or mercury vapour. , 1990, British journal of industrial medicine.

[32]  A. Poklis The lead content of the aorta in male residents of Baltimore, Maryland , 1975, Bulletin of environmental contamination and toxicology.

[33]  H. Hense,et al.  The Association of Blood Lead and Blood Pressure in Population Surveys , 1993, Epidemiology.

[34]  François Mariotti,et al.  Dose‐response analyses using restricted cubic spline functions in public health research , 2010, Statistics in medicine.

[35]  P Whelton,et al.  Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. , 1995, Hypertension.

[36]  P. Whelton,et al.  Blood Lead Level Is Associated With Elevated Blood Pressure in Blacks , 2003, Hypertension.

[37]  S. Garrett,et al.  Cadmium, environmental exposure, and health outcomes. , 2011, Ciencia & saude coletiva.

[38]  N. Vaziri,et al.  Effect of Lead on Nitric Oxide Synthase Expression in Coronary Endothelial Cells: Role of Superoxide , 2001, Hypertension.

[39]  J. Schwartz,et al.  Cumulative Community-Level Lead Exposure and Pulse Pressure: The Normative Aging Study , 2007, Environmental health perspectives.

[40]  A. Rotnitzky,et al.  The relationship of bone and blood lead to hypertension. The Normative Aging Study. , 1996, JAMA.

[41]  J. Schwartz,et al.  The relationship between blood lead and blood pressure in the NHANES II survey. , 1988, Environmental health perspectives.

[42]  Warren Friedman,et al.  The prevalence of lead-based paint hazards in U.S. housing. , 2002, Environmental health perspectives.

[43]  E. Guallar,et al.  Bone Lead Levels and Blood Pressure Endpoints: A Meta-Analysis , 2008, Epidemiology.

[44]  K. Hsu,et al.  Environmental lead exposure and progression of chronic renal diseases in patients without diabetes. , 2003, The New England journal of medicine.

[45]  J. Staessen,et al.  An epidemiological re-appraisal of the association between blood pressure and blood lead: a meta-analysis , 2002, Journal of Human Hypertension.