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

Journal article
Authors A. Gambelunghe
Gerd Sällsten
Y. Borne
Niklas Forsgard
B. Hedblad
P. Nilsson
Björn Fagerberg
G. Engstrom
Lars Barregård
Published in Environmental Research
Volume 149
Pages 157-163
ISSN 0013-9351
Publication year 2016
Published at Wallenberg Laboratory
Institute of Medicine, School of Public Health and Community Medicine
Pages 157-163
Language en
Keywords Blood lead, Blood pressure, Hypertension, Cohort, Cadmium, cardiovascular-disease, malmo diet, cadmium exposure, national-health, risk-factors, cancer, period, women, metaanalysis, mechanisms, Environmental Sciences & Ecology, Public, Environmental & Occupational, Health
Subject categories Health Sciences


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 Malmo, 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 anti hypertensive medication. Blood lead was calculated from lead in erythrocytes and haematocrit. Multi variable 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 mu g/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 halflife 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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