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Exposure to Lead and Coronary Artery Atherosclerosis : A Swedish Cross-Sectional Population-Based Study

Rosengren, Erik ; Barregard, Lars ; Sallsten, Gerd ; Fagerberg, Björn ; Engström, Gunnar LU ; Fagman, Erika ; Forsgard, Niklas ; Lundh, Thomas LU ; Bergström, Göran and Harari, Florencia (2025) In Journal of the American Heart Association 14(5).
Abstract

BACKGROUND: Lead is an established causal risk factor for coronary heart disease. Atherosclerosis may be the key mediator for this association, but evidence from studies in humans is limited. Our objective was to test the hypothesis that environmental lead exposure is associated with coronary atherosclerosis. METHODS: We used cross-sectional data from the SCAPIS (Swedish Cardiopulmonary Bioimage Study), including 5627 men and women aged 50 to 64 years. Coronary artery calcium score (CACS), measured using computed tomography, was used as a marker of atherosclerosis, and blood lead was used as a biomarker of lead exposure. The prevalence ratio (PR) of positive (>0) and high (≥100) CACSs in relation to blood lead (continuous variable)... (More)

BACKGROUND: Lead is an established causal risk factor for coronary heart disease. Atherosclerosis may be the key mediator for this association, but evidence from studies in humans is limited. Our objective was to test the hypothesis that environmental lead exposure is associated with coronary atherosclerosis. METHODS: We used cross-sectional data from the SCAPIS (Swedish Cardiopulmonary Bioimage Study), including 5627 men and women aged 50 to 64 years. Coronary artery calcium score (CACS), measured using computed tomography, was used as a marker of atherosclerosis, and blood lead was used as a biomarker of lead exposure. The prevalence ratio (PR) of positive (>0) and high (≥100) CACSs in relation to blood lead (continuous variable) was modeled using Poisson regression with robust SEs, adjusted for age, sex, smoking, low-density lipoprotein/high-density lipoprotein ratio, waist circumference, heredity for cardiovascular diseases, statin use, diabetes, blood cadmium, low physical activity, and educational level. RESULTS: Median blood lead was 14.2 μg/L. Positive CACS (prevalence, 41%) was not significantly associated with blood lead (PR per Δ10 μg/L, 1.02 [95% CI, 0.99–1.04]), whereas the association was stronger for high CACS (prevalence, 13%; and PR per Δ10 μg/L, 1.05 [95% CI, 1.00–1.11]). The estimate for high CACS was stronger in men (PR per Δ10 μg/L, 1.07 [95% CI, 1.01–1.13]) than among women (PR per Δ10 μg/L, 1.01 [95% CI, 0.85–1.20]). CONCLUSIONS: Our study, which found that lead is associated with coronary artery calcification in men, provides further evidence that lead is a risk factor for atherosclerosis and coronary heart disease.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atherosclerosis, coronary artery disease, environmental exposure, lead
in
Journal of the American Heart Association
volume
14
issue
5
article number
e037633
publisher
Wiley-Blackwell
external identifiers
  • scopus:86000207198
  • pmid:40035389
ISSN
2047-9980
DOI
10.1161/JAHA.124.037633
language
English
LU publication?
yes
id
c941be6a-971f-4ead-94a2-08dfe7b5942a
date added to LUP
2025-06-19 10:44:21
date last changed
2025-07-17 13:50:09
@article{c941be6a-971f-4ead-94a2-08dfe7b5942a,
  abstract     = {{<p>BACKGROUND: Lead is an established causal risk factor for coronary heart disease. Atherosclerosis may be the key mediator for this association, but evidence from studies in humans is limited. Our objective was to test the hypothesis that environmental lead exposure is associated with coronary atherosclerosis. METHODS: We used cross-sectional data from the SCAPIS (Swedish Cardiopulmonary Bioimage Study), including 5627 men and women aged 50 to 64 years. Coronary artery calcium score (CACS), measured using computed tomography, was used as a marker of atherosclerosis, and blood lead was used as a biomarker of lead exposure. The prevalence ratio (PR) of positive (&gt;0) and high (≥100) CACSs in relation to blood lead (continuous variable) was modeled using Poisson regression with robust SEs, adjusted for age, sex, smoking, low-density lipoprotein/high-density lipoprotein ratio, waist circumference, heredity for cardiovascular diseases, statin use, diabetes, blood cadmium, low physical activity, and educational level. RESULTS: Median blood lead was 14.2 μg/L. Positive CACS (prevalence, 41%) was not significantly associated with blood lead (PR per Δ10 μg/L, 1.02 [95% CI, 0.99–1.04]), whereas the association was stronger for high CACS (prevalence, 13%; and PR per Δ10 μg/L, 1.05 [95% CI, 1.00–1.11]). The estimate for high CACS was stronger in men (PR per Δ10 μg/L, 1.07 [95% CI, 1.01–1.13]) than among women (PR per Δ10 μg/L, 1.01 [95% CI, 0.85–1.20]). CONCLUSIONS: Our study, which found that lead is associated with coronary artery calcification in men, provides further evidence that lead is a risk factor for atherosclerosis and coronary heart disease.</p>}},
  author       = {{Rosengren, Erik and Barregard, Lars and Sallsten, Gerd and Fagerberg, Björn and Engström, Gunnar and Fagman, Erika and Forsgard, Niklas and Lundh, Thomas and Bergström, Göran and Harari, Florencia}},
  issn         = {{2047-9980}},
  keywords     = {{atherosclerosis; coronary artery disease; environmental exposure; lead}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of the American Heart Association}},
  title        = {{Exposure to Lead and Coronary Artery Atherosclerosis : A Swedish Cross-Sectional Population-Based Study}},
  url          = {{http://dx.doi.org/10.1161/JAHA.124.037633}},
  doi          = {{10.1161/JAHA.124.037633}},
  volume       = {{14}},
  year         = {{2025}},
}