Association of blood lead to blood pressure in men aged 55 to 75 years: effect of selected social and biochemical confounders. NFR Study Group.

Abstract

The association of blood lead (B-Pb) concentration to blood pressure was investigated in men aged 55 to 75 years living in the Rome area, who had no history of exposure to lead in the workplace and who participated between 1989 and 1990 in an epidemiologic survey for coronary heart disease (New Risk Factor Project). Of the 1856 individuals eligible for the study, 59 were excluded from analyses because not all relevant data were available; and 478 were excluded because they were treated for hypertension. In the remaining subjects (n = 1319) the median B-Pb concentration was 113 pg/l (range: 40-442 pg/I). Systolic blood pressure (SBP) averaged 140 ± 18 (standard deviation) mm Hg (range 98-220) and diastolic blood pressure (DBP) 84 ± 9 mm Hg (range 56-118). Median B-Pb values increased significantly from 1 1 1 pg/l in subjects with normal blood pressure (n = 668) to 1 13.5 pg/l in subjects with borderline high blood pressure (n = 373) and to 120 pg/l in subjects with increased blood pressure (n = 278). After log-normal conversion of B-Pb, the linear correlation coefficient between ln[B-Pb(ug/l)] and both SBP and DBP was statistically significant (r = 0.1332, p <0.001 and r = 0.0737, p = 0.007, respectively). The linear regression coefficient was 6.8 mm Hg/ln(pg/l) for SBP and 1.8 mm Hg/ln(pg/l) for DBP. Multiple regression analyses revealed that, after correction for body mass index (BMI), age, heart rate, skinfold thickness, serum lipids, and glucose levels, blood lead was still a significant predictor of increased SBP and DBP. The adjusted regression coefficient was 5.6 mm HgAn(ug/l) for SBP and 1.7 mm Hg/ln(pg/l) for DBP. In further analyses subjects were divided, according to alcohol consumption, into drinkers (n = 1068) and nondrinkers (n = 251). Among nondrinkers the median B-Pb levels was 97 pg/l (2.5th and 97.5th centiles 55-181 pg/I) and SBP and DBP averaged 138 ± 17 and 84 ± 9 mm Hg, respectively. No significant relationship between In[B-Pb] and blood pressure was found. In drinkers the median B-Pb level was 1 17 pg/l (2.5th and 97.5th centiles: 63-252 pg/I) and SBP and DBP averaged 141 ± 18 and 84 ± 9 mm Hg, respectively. The linear regression coefficient was 7.5 mm Hg/ln(pg/l) for SBP and 2.6 mm Hg/ln(pg/l) for DBP. In multiple stepwise regressions including BMI, age, heart rate, smoking, skinfold thickness, serum lipids, and glucose levels as covariates-the partial correlation coefficient of systolic and diastolic blood pressure with In[B-Pb] remained statistically significant. The adjusted regression coefficients were 5.6 mm Hg/ln(pg/l) for SBP and 2.5 mm Hg/ln(pg/l) for DBP. These findings indicate that a slight to moderate positive relationship exists between blood pressure and blood lead concentrations in male drinkers aged 55 to 75 years. -Environ Health Perspect 102(Suppl 9): 107-111 (1994)

Association between blood levels of lead, blood pressure and risk of diabetes and heart disease in workers

“…Results of previous studies have supported the association between blood lead and blood pressure (Cramer and Dahlberg 1966;Beevers et al 1976;Pocock et al 1984;Menditto et al 1994;Pikle et al 1985;Apostoli 1998). In addition, signi®cant correlations between blood lead and a variety of risk factors for cardiovascular disease (CVD) such as hypertension (Wu et al 1996;Schwartz 1988;Weiss et al 1986), and diabetes mellitus (DM) have been well-established Hayashi et al 1999);Schwartz 1995;DeFronzo 1997;Bener et al 2000).…”

Blood lead and blood pressure: evidence from the Health Survey for England 1995

“…5 The handling of respondents on antihypertensive medication has varied in previous studies. Some studies have excluded those on treatment 20 thus reducing the power of the regression analysis and possibly excluding those most susceptible to any lead-induced increase in BP. However most studies have included those on treatment, thereby introducing potential bias because the BP recorded for those on treatment is lower than their 'true' pressure were they not on medication.…”

An epidemiological re-appraisal of the association between blood pressure and blood lead: a meta-analysis

“…Journal of Human Hypertension lead without any adjustment for possible confounders and one 49 reported only the unadjusted association size with sufficient detail to be included in the analysis. In all but six reports, 13,16,34,40,49,63 the results were adjusted for age.…”

“…In all but six reports, 13,16,34,40,49,63 the results were adjusted for age. However, in one of these six reports all subjects were of the same age.…”