Abstract
The aim of this study was to investigate the association between blood lead level (BLL) and hypertension in adults when lead exposure for the general population is low. The study used data from the US National Health and Nutrition Examination Survey (NHANES) 1999–2016. Participants aged 20 to 79 years were included in our study. Weighted multiple linear regression and logistic regression were conducted to test the association between BLL and systolic/diastolic blood pressure and hypertension status, respectively, while controlling for age, gender, race/ethnicity, body mass index, income level, and education. A total of 30,467 participants were included in this study. There was no association between BLL and hypertension status for the overall sample. Among those who were not taking antihypertensive medication, after adjusting for covariates, systolic blood pressure was positively correlated with BLL in non-Hispanic Whites (P = 0.004) and non-Hispanic Blacks (P = 0.0005), but not Hispanics (P = 0.07) nor Others (P = 0.37). The relationship between diastolic blood pressure and lead levels was also significant in non-Hispanic Whites and non-Hispanic Blacks. This study showed that higher BLL was associated with higher systolic and diastolic blood pressure in some population groups, but not associated with hypertension status.
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References
Baneras J et al (2018) Short-term exposure to air pollutants increases the risk of ST elevation myocardial infarction and of infarct-related ventricular arrhythmias and mortality. Int J Cardiol 250:35–42. https://doi.org/10.1016/j.ijcard.2017.10.004
Centers for Disease Control and Prevention (2013) National Health and Nutrition Examination Survey (NHANES) Physician Examination Procedures Manual. https://wwwn.cdc.gov/nchs/data/nhanes/2013-2014/manuals/Phys_Exam_Manual_2013.pdf. 2020
Centers for Disease Control and Prevention (2018a) Lead: health problems caused by lead - NIOSH workplace safety and health topic. https://www.cdc.gov/niosh/topics/lead/health.html
Centers for Disease Control and Prevention (2018b) NHANES tutorials - module 3 - weighting. https://wwwn.cdc.gov/nchs/nhanes/tutorials/module3.aspx
Centers for Disease Control and Prevention (2019) National health and nutrition examination survey. https://wwwn.cdc.gov/nchs/nhanes/Default.aspx. Accessed Dec 12 2019
Chowdhury R, Ramond A, O’Keeffe LM, Shahzad S, Kunutsor SK, Muka T, Gregson J, Willeit P, Warnakula S, Khan H, Chowdhury S, Gobin R, Franco OH, di Angelantonio E (2018) Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. Bmj 362:k3310. https://doi.org/10.1136/bmj.k3310
Crim MT et al (2012) National surveillance definitions for hypertension prevalence and control among adults. Circ Cardiovasc Qual Outcomes 5:343–351. https://doi.org/10.1161/CIRCOUTCOMES.111.963439
Den Hond E, Nawrot T, Staessen JA (2002) The relationship between blood pressure and blood lead in NHANES III. National Health and Nutritional Examination Survey. J Hum Hypertens 16:563–568. https://doi.org/10.1038/sj.jhh.1001452
Fiorim J, Ribeiro Júnior RF, Silveira EA, Padilha AS, Vescovi MVA, de Jesus HC, Stefanon I, Salaices M, Vassallo DV (2011) Low-Level Lead Exposure Increases Systolic Arterial Pressure and Endothelium-Derived Vasodilator Factors in Rat Aortas. PLoS One 6:6. https://doi.org/10.1371/journal.pone.0017117
Flack JM, Adekola B (2020) Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med 30:160–164. https://doi.org/10.1016/j.tcm.2019.05.003
Geier DA, Kern JK, Geier MR (2017) Blood lead levels and learning disabilities: a cross-sectional study of the 2003-2004. National Health and Nutrition Examination Survey (NHANES). Int J Environ Res Public Health:14. https://doi.org/10.3390/ijerph14101202
Glenn BS, Bandeen-Roche K, Lee B-K, Weaver VM, Todd AC, Schwartz BS (2006) Changes in Systolic Blood Pressure Associated with Lead in Blood and Bone. Epidemiology 17:538–544
Hara A et al (2015) Blood pressure in relation to environmental lead exposure in the national health and nutrition examination survey 2003 to 2010. Hypertension 65:62–69. https://doi.org/10.1161/HYPERTENSIONAHA.114.04023
Harlan WR, Landis JR, Schmouder RL, Goldstein NG, Harlan LC (1985) Blood Lead and Blood Pressure: Relationship in the Adolescent and Adult US Population. JAMA 253:530–534. https://doi.org/10.1001/jama.1985.03350280086025
Hu H, Rabinowitz M, Smith D (1998) Bone lead as a biological marker in epidemiologic studies of chronic toxicity: conceptual paradigms. Environ Health Perspect 106:1–8
Jain RB (2019) Co-exposures to toxic metals cadmium, lead, and mercury and their impact on unhealthy kidney function. Environ Sci Pollut Res Int 26:30112–30118. https://doi.org/10.1007/s11356-019-06182-y
Kasperczyk S, Kasperczyk J, Ostalowska A, Zalejska-Fiolka J, Wielkoszynski T, Swietochowska E, Birkner E (2009) The role of the antioxidant enzymes in erythrocytes in the development of arterial hypertension among humans exposed to lead. Biol Trace Elem Res 130:95–106. https://doi.org/10.1007/s12011-009-8323-z
Menke A, Muntner P, Batuman V, Silbergeld EK, Guallar E (2006) Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults. Circulation 114:1388–1394. https://doi.org/10.1161/CIRCULATIONAHA.106.628321
Muntner P, Menke A, DeSalvo KB, Rabito FA, Batuman V (2005) Continued Decline in Blood Lead Levels Among Adults in the United States: The National Health and Nutrition Examination Surveys. Arch Intern Med 165:2155–2161. https://doi.org/10.1001/archinte.165.18.2155
Navas-Acien A, Guallar E, Silbergeld EK, Rothenberg SJ (2007) Lead exposure and cardiovascular disease--a systematic review. Environ Health Perspect 115:472–482. https://doi.org/10.1289/ehp.9785
Orr SE, Bridges CC (2017) Chronic kidney disease and exposure to nephrotoxic metals. Int J Mol Sci 18. https://doi.org/10.3390/ijms18051039
Patrick L (2006) Lead toxicity, a review of the literature. Part 1: exposure, evaluation, and treatment. Altern Med Rev 11:2–22
Pirkle JL, Brody DJ, Gunter EW, Kramer RA, Paschal DC, Flegal KM, Matte TD (1994) The Decline in Blood Lead Levels in the United States: The National Health and Nutrition Examination Surveys (NHANES). JAMA 272:284–291. https://doi.org/10.1001/jama.1994.03520040046039
Pirkle JL, Kaufmann RB, Brody DJ, Hickman T, Gunter EW, Paschal DC (1998) Exposure of the U.S. population to lead, 1991-1994. Environ Health Perspect 106:745–750. https://doi.org/10.1289/ehp.98106745
Said S, Hernandez GT (2015) Environmental exposures, socioeconomics, disparities, and the kidneys. Adv Chronic Kidney Dis 22:39–45. https://doi.org/10.1053/j.ackd.2014.09.003
Schwartz J (1988) The relationship between blood lead and blood pressure in the NHANES II survey. Environ Health Perspect 78:15–22
Scinicariello F, Abadin H, Murray E (2011) Association of low-level blood lead and blood pressure in NHANES 1999–2006. Environ Res 111:1249–1257
Simões MR, Ribeiro Júnior RF, Vescovi MVA, de Jesus HC, Padilha AS, Stefanon I, Vassallo DV, Salaices M, Fioresi M (2011) Acute Lead Exposure Increases Arterial Pressure: Role of the Renin-Angiotensin System. PLoS One 6:6. https://doi.org/10.1371/journal.pone.0018730
Simoes MR et al (2017) Low-level chronic Lead exposure impairs neural control of blood pressure and heart rate in rats. Cardiovasc Toxicol 17:190–199. https://doi.org/10.1007/s12012-016-9374-y
Vanai VM, Piasek M, Blanusa M (2001) Succimer treatment during ongoing lead exposure reduces tissue lead in suckling rats - Varnai - 2001. J Appl Toxicol. https://doi.org/10.1002/jat.772
Vupputuri S, He J, Muntner P, Bazzano LA, Whelton PK, Batuman V (2003) Blood lead level is associated with elevated blood pressure in blacks. Hypertension 41:463–468. https://doi.org/10.1161/01.hyp.0000055015.39788.29
World Health Organization (2019) Lead poisoning and health. https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health
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Teye, S.O., Yanosky, J.D., Cuffee, Y. et al. Association between blood lead levels and blood pressure in American adults: results from NHANES 1999–2016. Environ Sci Pollut Res 27, 45836–45843 (2020). https://doi.org/10.1007/s11356-020-10381-3
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DOI: https://doi.org/10.1007/s11356-020-10381-3