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International Archives of Occupational and Environmental Health

Published in:

01-04-2015 | Original Article

Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults

Authors: Mohammed F. Faramawi, Robert Delongchamp, Yu-Sheng Lin, Youcheng Liu, Saly Abouelenien, Lori Fischbach, Supriya Jadhav

Published in: International Archives of Occupational and Environmental Health | Issue 3/2015

Abstract

Purpose

The association between environmental lead exposure and blood pressure variability, an important risk factor for cardiovascular disease, is unexplored and unknown. The objective of the study was to test the hypothesis that lead exposure is associated with blood pressure variability.

Methods

American participants 17 years of age or older from National Health and Nutrition Examination Survey III were included in the analysis. Participants’ blood lead concentrations expressed as micrograms per deciliter were determined. The standard deviations of visit-to-visit systolic and diastolic blood pressure were calculated to determine blood pressure variability. Multivariable regression analyses adjusted for age, gender, race, smoking and socioeconomic status were employed.

Results

The participants’ mean age and mean blood lead concentration were 42.72 years and 3.44 mcg/dl, respectively. Systolic blood pressure variability was significantly associated with environmental lead exposure after adjusting for the effect of the confounders. The unadjusted and adjusted means of visit-to-visit systolic blood pressure variability and the β coefficient of lead exposure were 3.44, 3.33 mcg/dl, β coefficient = 0.07, P < 0.01.

Conclusions

This study documents a positive linear relationship between environmental lead exposure and systolic blood pressure variability. Screening adults with fluctuating blood pressure for lead exposure could be warranted.

Alley DE, Seeman TE, Ki Kim J, Karlamangla A, Hu P, Crimmins EM (2006) Socioeconomic status and C-reactive protein levels in the US population: NHANES IV. Brain Behav Immun 20(5):498–504. doi:10.1016/j.bbi.2005.10.003 CrossRef

Analytic and reporting guidelines: The Third National Health Nutrition Survey NHANES III (1988–1994) NCfHS, Center for Disease Control and Prevention. (Accessed 2014). http://www.cdc.gov/nchs/data/nhanes/nhanes3/nh3gui.pdf

Annest JL, Pirkle JL, Makuc D, Neese JW, Bayse DD, Kovar MG (1983) Chronological trend in blood lead levels between 1976 and 1980. N Engl J Med 308(23):1373–1377. doi:10.1056/NEJM198306093082301 CrossRef

Benowitz NL (1999) Biomarkers of environmental tobacco smoke exposure. Environ Health Perspect 107(Suppl. 2):349–355CrossRef

Centers for Disease Control and Prevention (1991) Control of excessive lead exposure in radiator repair workers. MMWR Morb Mortal Wkly Rep 40(8):139–141

Chang SH et al (2006) Low blood lead concentration in association with infertility in women. Environ Res 101(3):380–386. doi:10.1016/j.envres.2005.10.004 CrossRef

Cheng Y, Schwartz J, Sparrow D, Aro A, Weiss ST, Hu H (2001) Bone lead and blood lead levels in relation to baseline blood pressure and the prospective development of hypertension: the Normative Aging Study. Am J Epidemiol 153(2):164–171CrossRef

Diaz KM et al (2012) Relationship of visit-to-visit and ambulatory blood pressure variability to vascular function in African Americans. Hypertens Res 35(1):55–61. doi:10.1038/hr.2011.135 CrossRef

Egan BM, Zhao Y, Axon RN (2010) US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA 303(20):2043–2050. doi:10.1001/jama.2010.650 CrossRef

Faramawi MF, Delongchamp R, Said Q, Jadhav S, Abouelenien S (2014) Metabolic syndrome is associated with visit-to-visit systolic blood pressure variability in the US adults. Hypertens Res. doi:10.1038/hr.2014.89

Grassi G, Bombelli M, Brambilla G, Trevano FQ, Dell’oro R, Mancia G (2012) Total cardiovascular risk, blood pressure variability and adrenergic overdrive in hypertension: evidence, mechanisms and clinical implications. Curr Hypertens Rep 14(4):333–338. doi:10.1007/s11906-012-0273-8 CrossRef

Kamel F, Umbach DM, Munsat TL, Shefner JM, Hu H, Sandler DP (2002) Lead exposure and amyotrophic lateral sclerosis. Epidemiology 13(3):311–319CrossRef

Khan DA, Qayyum S, Saleem S, Khan FA (2009) Evaluation of lead body burden in occupational workers by lead mobilization test. J Pak Med Assoc 59(6):350–354

Kim R, Rotnitsky A, Sparrow D, Weiss S, Wager C, Hu H (1996) A longitudinal study of low-level lead exposure and impairment of renal function. The Normative Aging Study. JAMA 275(15):1177–1181CrossRef

Kosnett MJ et al (2007) Recommendations for medical management of adult lead exposure. Environ Health Perspect 115(3):463–471. doi:10.1289/ehp.9784 CrossRef

Levitan EB, Kaciroti N, Oparil S, Julius S, Muntner P (2013) Relationships between metrics of visit-to-visit variability of blood pressure. J Hum Hypertens 27(10):589–593. doi:10.1038/jhh.2013.19 CrossRef

Lind L, Berglund L, Larsson A, Sundstrom J (2011) Endothelial function in resistance and conduit arteries and 5-year risk of cardiovascular disease. Circulation 123(14):1545–1551. doi:10.1161/CIRCULATIONAHA.110.984047 CrossRef

Mudipalli A (2007) Lead hepatotoxicity and potential health effects. Indian J Med Res 126(6):518–527

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(18):2155–2161. doi:10.1001/archinte.165.18.2155 CrossRef

National Center for Health Statistics (1994) Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94. Vital and Health Statistics. Series 1: Programs and collection procedures, No 32

Parati G, Ochoa JE, Lombardi C, Bilo G (2013a) Assessment and management of blood-pressure variability. Nat Rev Cardiol 10(3):143–155CrossRef

Parati G, Ochoa JE, Salvi P, Lombardi C, Bilo G (2013b) Prognostic value of blood pressure variability and average blood pressure levels in patients with hypertension and diabetes. Diabetes Care 36(Suppl. 2):S312–S324. doi:10.2337/dcS13-2043 CrossRef

Perkovic V, Huxley R, Wu Y, Prabhakaran D, MacMahon S (2007) The burden of blood pressure-related disease: a neglected priority for global health. Hypertension 50(6):991–997. doi:10.1161/HYPERTENSIONAHA.107.095497 CrossRef

Perlstein T et al (2007) Cumulative community-level lead exposure and pulse pressure: the normative aging study. Environ Health Perspect 115(12):1696–1700. doi:10.1289/ehp.10350 CrossRef

Pirkle JL, Kaufmann RB, Brody DJ, Hickman T, Gunter EW, Paschal DC (1998) Exposure of the US population to lead, 1991–1994. Environ Health Perspect 106(11):745–750CrossRef

Rossignol P, Kessler M, Zannad F (2013) Visit-to-visit blood pressure variability and risk for progression of cardiovascular and renal diseases. Curr Opin Nephrol Hypertens 22(1):59–64. doi:10.1097/MNH.0b013e32835b489f CrossRef

Rothwell PM et al (2010) Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet 375(9718):895–905. doi:10.1016/S0140-6736(10)60308-X CrossRef

Schwartz BS et al (2000) Past adult lead exposure is associated with longitudinal decline in cognitive function. Neurology 55(8):1144–1150CrossRef

Todd AC, Lee BK, Lee GS, Ahn KD, Moshier EL, Schwartz BS (2001) Predictors of DMSA chelatable lead, tibial lead, and blood lead in 802 Korean lead workers. Occup Environ Med 58(2):73–80CrossRef

Tong S, von Schirnding YE, Prapamontol T (2000) Environmental lead exposure: a public health problem of global dimensions. Bull World Health Organ 78(9):1068–1077

van den Bogaard B, Westerhof BE, van den Born B-JH (2010) Prognostic significance of blood-pressure variability. Lancet 376(9739):413CrossRef

Vaziri ND (2002) Pathogenesis of lead-induced hypertension: role of oxidative stress. J Hypertens Suppl. 20(3):S15–S20

Vaziri ND, Ding Y (2001) Effect of lead on nitric oxide synthase expression in coronary endothelial cells: role of superoxide. Hypertension 37(2):223–226CrossRef

Vaziri ND, Ding Y, Ni Z (1999) Nitric oxide synthase expression in the course of lead-induced hypertension. Hypertension 34(4 Pt 1):558–562CrossRef

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(3):463–468. doi:10.1161/01.HYP.0000055015.39788.29 CrossRef

Title: Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults
Authors: Mohammed F. Faramawi
Robert Delongchamp
Yu-Sheng Lin
Youcheng Liu
Saly Abouelenien
Lori Fischbach
Supriya Jadhav
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 3/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-014-0970-5

At a glance: The STEP trials

Springer Medicine

Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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