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Low-level exposure to lead, blood pressure, and hypertension in a population-based cohort

Gambelunghe, Angela; Sallsten, Gerd; Borné, Yan LU ; Forsgard, Niklas; Hedblad, Bo LU ; Nilsson, Peter LU ; Fagerberg, Björn; Engström, Gunnar LU and Barregard, Lars (2016) In Environmental Research 149. p.157-163
Abstract

Background: Environmental lead exposure is a possible causative factor for increased blood pressure and hypertension, but large studies at low-level exposure are scarce, and results inconsistent. Objective: We aimed to examine the effects of environmental exposure to lead in a large population-based sample. Methods: We assessed associations between blood lead and systolic/diastolic blood pressure and hypertension in 4452 individuals (46-67 years) living in Malmö, Sweden, in 1991-1994. Blood pressure was measured using a mercury sphygmomanometer after 10 min supine rest. Hypertension was defined as high systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure and/or current use of antihypertensive medication. Blood lead was calculated... (More)

Background: Environmental lead exposure is a possible causative factor for increased blood pressure and hypertension, but large studies at low-level exposure are scarce, and results inconsistent. Objective: We aimed to examine the effects of environmental exposure to lead in a large population-based sample. Methods: We assessed associations between blood lead and systolic/diastolic blood pressure and hypertension in 4452 individuals (46-67 years) living in Malmö, Sweden, in 1991-1994. Blood pressure was measured using a mercury sphygmomanometer after 10 min supine rest. Hypertension was defined as high systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure and/or current use of antihypertensive medication. Blood lead was calculated from lead in erythrocytes and haematocrit. Multivariable associations between blood lead and blood pressure or hypertension were assessed by linear and logistic regression. Two-thirds of the cohort was re-examined 16 years later. Results: At baseline, mean blood pressure was 141/87 mmHg, 16% used antihypertensive medication, 63% had hypertension, and mean blood lead was 28 μg/L. Blood lead in the fourth quartile was associated with significantly higher systolic and diastolic blood pressure (point estimates: 1-2 mmHg) and increased prevalence of hypertension (odds ratio: 1.3, 95% confidence interval: 1.1-1.5) versus the other quartiles after adjustment for sex, age, smoking, alcohol, waist circumference, and education. Associations were also significant with blood lead as a continuous variable. Blood lead at baseline, having a half-life of about one month, was not associated with antihypertensive treatment at the 16-year follow-up. Conclusions: Low-level lead exposure increases blood pressure and may increase the risk of hypertension.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood lead, Blood pressure, Cadmium, Cohort, Hypertension
in
Environmental Research
volume
149
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:84968853353
  • wos:000378366000017
ISSN
0013-9351
DOI
10.1016/j.envres.2016.05.015
language
English
LU publication?
yes
id
ae78d617-4fc6-4b67-8bd9-904b2229630d
date added to LUP
2016-12-09 14:15:02
date last changed
2017-09-17 09:34:09
@article{ae78d617-4fc6-4b67-8bd9-904b2229630d,
  abstract     = {<p>Background: Environmental lead exposure is a possible causative factor for increased blood pressure and hypertension, but large studies at low-level exposure are scarce, and results inconsistent. Objective: We aimed to examine the effects of environmental exposure to lead in a large population-based sample. Methods: We assessed associations between blood lead and systolic/diastolic blood pressure and hypertension in 4452 individuals (46-67 years) living in Malmö, Sweden, in 1991-1994. Blood pressure was measured using a mercury sphygmomanometer after 10 min supine rest. Hypertension was defined as high systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure and/or current use of antihypertensive medication. Blood lead was calculated from lead in erythrocytes and haematocrit. Multivariable associations between blood lead and blood pressure or hypertension were assessed by linear and logistic regression. Two-thirds of the cohort was re-examined 16 years later. Results: At baseline, mean blood pressure was 141/87 mmHg, 16% used antihypertensive medication, 63% had hypertension, and mean blood lead was 28 μg/L. Blood lead in the fourth quartile was associated with significantly higher systolic and diastolic blood pressure (point estimates: 1-2 mmHg) and increased prevalence of hypertension (odds ratio: 1.3, 95% confidence interval: 1.1-1.5) versus the other quartiles after adjustment for sex, age, smoking, alcohol, waist circumference, and education. Associations were also significant with blood lead as a continuous variable. Blood lead at baseline, having a half-life of about one month, was not associated with antihypertensive treatment at the 16-year follow-up. Conclusions: Low-level lead exposure increases blood pressure and may increase the risk of hypertension.</p>},
  author       = {Gambelunghe, Angela and Sallsten, Gerd and Borné, Yan and Forsgard, Niklas and Hedblad, Bo and Nilsson, Peter and Fagerberg, Björn and Engström, Gunnar and Barregard, Lars},
  issn         = {0013-9351},
  keyword      = {Blood lead,Blood pressure,Cadmium,Cohort,Hypertension},
  language     = {eng},
  month        = {08},
  pages        = {157--163},
  publisher    = {Elsevier},
  series       = {Environmental Research},
  title        = {Low-level exposure to lead, blood pressure, and hypertension in a population-based cohort},
  url          = {http://dx.doi.org/10.1016/j.envres.2016.05.015},
  volume       = {149},
  year         = {2016},
}