Declining exposures to lead and cadmium contribute to explaining the reduction of cardiovascular mortality in the US population, 1988–2004

Ruiz-Hernandez, Adrian; Navas‐Acien, Ana; Pastor-Barriuso, Roberto; Crainiceanu, Ciprian M.; Redón, Josep; Güallar, Eliseo; Téllez-Plaza, María

doi:10.1093/ije/dyx176

Cited by 81 publications

(70 citation statements)

References 49 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As discussed in several reviews and reports (EFSA 2010;Navas-Acien et al 2007;NTP 2012;Solenkova et al 2014), a number of studies have shown associations between environmental lead exposure and cardiovascular disease and mortality in cohorts with low-level lead exposure (B-Pb concentrations <50 lg=L). Five American studies on low-level environmental lead exposure (NHANES data) showed consistent associations between B-Pb concentrations and cardiovascular mortality (Lanphear et al 2018;Lustberg and Silbergeld 2002;Menke et al 2006;Ruiz-Hernandez et al 2017;Schober et al 2006). An increased risk of cardiovascular mortality has also been found at high levels of lead exposure in several occupational cohorts (Navas-Acien et al 2007;Skerfving and Bergdahl 2015).…”

Section: Discussionmentioning

confidence: 97%

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Harari

Barregård

Östling

et al. 2019

Environ Health Perspect

View full text Add to dashboard Cite

BACKGROUND: Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce. OBJECTIVES: Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrations and the prevalence of atherosclerotic plaque in the carotid artery. METHODS: We used cross-sectional data from the Malmö Diet and Cancer Study cardiovascular cohort (MDCS-CC; recruitment in 1991-1994) covering 4,172 middle-aged men and women. B-Pb at baseline, measured by inductively coupled plasma mass spectrometry, was used as the exposure biomarker. The presence of atherosclerotic plaque in the carotid artery was determined by B-mode ultrasonography. We used logistic regression to estimate odds ratios (ORs) for prevalence of plaque in the carotid artery according to B-Pb quartiles. RESULTS: The median B-Pb was 25 lg=L (range: 1.5-258), and 36% of the cohort had any atherosclerotic plaque. After controlling for confounders and known cardiovascular risk factors, the OR for prevalence of plaque in the highest quartile (Q4) of B-Pb compared with the lowest quartile (Q1) was 1.35 (95% CI: 1.09, 1.66) in the total group, 1.58 (95% CI: 1.20, 2.08) among women, and 1.18 (95% CI: 0.83, 1.69) among men. Among women, associations were limited to those who were postmenopausal [OR for Q4 vs. Q1 = 1.72 (95% CI: 1.26, 2.34) vs. OR = 0.96 (95% CI: 0.49, 1.89 in premenopausal women)]. Associations were weak and nonsignificant in never-smokers [OR for Q4 vs. Q1 = 1.14 (95% CI: 0.81, 1.61)]. DISCUSSION: Our study shows an association between B-Pb concentrations and occurrence of atherosclerotic plaque in the carotid artery, adding evidence for an underlying pro-atherogenic role of lead in cardiovascular disease. Associations appeared to be limited to postmenopausal (vs. premenopausal) women.

show abstract

Section: Discussionmentioning

confidence: 97%

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Harari

Barregård

Östling

et al. 2019

Environ Health Perspect

View full text Add to dashboard Cite

show abstract

“…The impact of Pb exposure on increased risk of CVD mortality has been observed in several epidemiological studies (Aoki et al 2016;Khalil et al 2009;Lanphear et al 2018;Menke et al 2006;Ruiz-Hernandez et al 2017;Schober et al 2006;Weisskopf et al 2015). In addition, the U.S.…”

Section: Introductionmentioning

confidence: 92%

“…EPA 2013). Recent evidence has suggested that exposure to Pb in adults can result in adverse cardiovascular impacts, including increases in hypertension (Muntner et al 2005;Navas-Acien et al 2008), coronary heart disease (Jain et al 2007), cardiovascular disease (CVD) (Chowdhury et al 2018;Guallar et al 2006;Muntner et al 2005;Navas-Acien et al 2004), and CVD-related mortality (CVD mortality) (Aoki et al 2016;Lanphear et al 2005;Menke et al 2006;Ruiz-Hernandez et al 2017). Mechanisms by which Pb may increase risk of death due to cardiovascular disease have been studied in in vitro and in vivo studies.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, several studies have demonstrated that there is a significant benefit of reducing blood Pb levels over time. For example, Ruiz-Hernandez et al (2017) investigated how the decreasing U.S. blood lead levels, as indicated by the differences in blood Pb observed in the 1988-1994 [i.e., National Health and Nutrition Examination Survey (NHANES III)] to 1999-2004 NHANES data sets, contributed to declining CVD mortality rates in the U.S. population. After adjusting for traditional CVD risk factors, the authors found that nearly 25% of avoided CVD-related deaths in the 1999-2004 data set were attributable to decreases in Pb exposure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Developing a Health Impact Model for Adult Lead Exposure and Cardiovascular Disease Mortality

Brown

Lynch

Belová

et al. 2020

Environ Health Perspect

View full text Add to dashboard Cite

BACKGROUND: Lead (Pb) is a highly toxic pollutant. Evidence suggests it is associated with cardiovascular disease (CVD)-related mortality. OBJECTIVES: We present a rigorous approach for identifying concentration-response functions that relate adult Pb exposures to CVD mortality to inform a health impact model (HIM). We then use the model in a proof-of-concept example. METHODS: Building on previously conducted government literature reviews and a de novo supplemental literature review, we compiled and evaluated the available data on Pb and CVD mortality in humans. We applied a set of predefined selection criteria to identify studies that would be most useful in understanding the impact of Pb exposure on CVD mortality risk in adults. Once we identified the studies, we derived a HIM and used each study's concentration-response function in a proof-of-concept example. RESULTS: Our literature search identified 15 studies for full-text review. Of those 15 studies, 4 fit our criteria for use in the HIM. Using population and CVD mortality rates for 40-to 80-y-olds in 2014, we estimated that 34,000-99,000 deaths have been avoided due to the lowering of blood Pb levels from 1999 to 2014. Based on these values we estimated that approximately 16%-46% of the decreased CVD-related death rate from 1999 to 2014 may be attributable to decreased blood Pb levels. CONCLUSION: Our results demonstrate that decreases in Pb exposure can result in large benefits for the adult population. We have provided a HIM that can be used in a variety of applications from burden-of-disease estimates to regulatory impact assessments and have demonstrated its sensitivity to the choice of concentration-response function.

show abstract

“…Concomitant with these reductions, cardiovascular mortality rates in the US decreased by 43% from 1988-94 to 1999-2004. 9 An analysis that accounted for traditional cardiovascular disease risk factors, showed that 32% of this reduction in cardiovascular mortality could be explained by the decline in lead and cadmium exposures. 9 The health impact of recent reductions in arsenic exposure, 10 however, has not been evaluated.…”

mentioning

confidence: 99%

Environmental metals and cardiovascular disease

Téllez-Plaza¹,

Güallar²,

Navas‐Acien³

2018

BMJ

Self Cite

View full text Add to dashboard Cite

show abstract

Declining exposures to lead and cadmium contribute to explaining the reduction of cardiovascular mortality in the US population, 1988–2004

Cited by 81 publications

References 49 publications

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

Developing a Health Impact Model for Adult Lead Exposure and Cardiovascular Disease Mortality

Environmental metals and cardiovascular disease

Contact Info

Product

Resources

About