Associations between lead concentrations and cardiovascular risk factors in U.S. adolescents

Xu, Cheng; Shu, Yaqin; Zhi, Fachao; Hu, Yuanli; Mo, Xuming

doi:10.1038/s41598-017-09701-4

Cited by 26 publications

(14 citation statements)

References 24 publications

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“…16 17 According to previous studies, both low and high lead concentrations have negative cardiovascular effects. [18][19][20][21][22][23] The cohort study of the National Health and Nutrition Examination Survey (NHANES) showed a dose-response relationship between blood lead level and mortality due to stroke (HR: 2.51, 95% CI: 1.20-5.26, p for trend=0.017). 18 Furthermore, a meta-analysis that pooled estimates of relative risk (RR) reported a 1.63-fold increased risk of stroke in individuals with elevated blood lead levels (RR: 1.63, 95% CI: 1.14-2.34).…”

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Association between blood lead level and risk of stroke in Korean adults: a cross-sectional study in the Korea National Health and Nutrition Examination Survey 2008–2013

et al. 2020

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ObjectivesAlthough lead is a potential risk factor for cardiovascular diseases such as stroke, research on this association in the Korean population remains limited. Therefore, we aimed to investigate the association between lead level and stroke in Korean adults.DesignA population-based cross-sectional study.SettingThe Korea National Health and Nutrition Examination Survey 2008–2013, which enrolled a representative sample of the Korean population.ParticipantsWe excluded participants younger than 20 years, missing weight data, pregnant or lactating, and missing blood lead and stroke data. A total of 11 510 participants were included in this analysis.Primary and secondary outcome measurementThe participants were classified by blood lead concentration into the low-level (≤2.189 µg/dL, n=5756) and high-level (>2.189 µg/dL, n=5754) groups. The main outcome, stroke, was assessed by information from physician diagnosis, prevalence of stroke or treatment for stroke. The ORs and 95% CIs were calculated to evaluate the association between blood lead level and stroke using multivariate logistic regression analysis.ResultsAlthough blood lead level was not significantly associated with stroke (OR: 1.30, 95% CI: 0.66–2.58) in the multivariate-adjusted model, in individuals with hypertension, the high-level group was 2.36-fold higher odds of stroke (OR: 2.36, 95% CI: 1.02–5.44) compared to that in the low-level group. No association was observed in individuals with normotension (OR: 0.42, 95% CI: 0.13–1.38, p for interaction=0.007).ConclusionThe association between blood lead concentration and stroke may be influenced by hypertension status. Our findings suggest the need for closer attention to lead exposure in patients with hypertension.

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Association between blood lead level and risk of stroke in Korean adults: a cross-sectional study in the Korea National Health and Nutrition Examination Survey 2008–2013

et al. 2020

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“…Studies found that some clinical markers in cardiovascular systems were associated with BLL, including blood pressure, high-density lipoprotein cholesterol, CRP, low-density lipoprotein cholesterol and homocysteine. [18][19][20] For example, a cross-sectional study in Baltimore revealed that homocysteine level increased 0.35 μmol/L with 1.0 μg/dL increase in blood lead. 21 Similarly, an Asian cross-sectional study found an increase of 1 μg/dL in blood lead was associated with an increase of 0.05 μmol/L in homocysteine.…”

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Modification of vitamin B6 on the associations of blood lead levels and cardiovascular diseases in the US adults

Wei

2020

BMJNPH

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BackgroundCardiovascular disease (CVD) is a leading cause of death in the US population. Lead exposure is an important risk factor of CVDs, as is associated with elevated homocysteine level and oxidative stress. We aim to examine whether vitamin B6, which has been shown to reduce homocysteine level, can modify the relationship between blood lead and the risk of CVDs.MethodsCross-sectional data on ever-report CVDs (congestive heart failure, coronary heart disease, angina pectoris, heart attack and stroke), blood lead level (BLL) and vitamin B6 in the form of plasma pyridoxal 5'-phosphate were obtained from US National Health and Nutrition Examination Survey 2005–2006 for adults≥20 years old. The association between CVDs and quartiles of BLL was estimated using multivariate logistic regression models adjusted for demographics factors, lifestyle variables, stress variables, comorbidities and CVD biomarkers (C reactive protein, homocysteine, cholesterol) and was stratified by vitamin B6 deficiency level (<20 nmol/L) and median value of vitamin B6 (42.5 nmol/L).ResultsPositive associations between BLL and CVDs only appeared in the vitamin B6 deficiency group, with quartile 2 to quartile 4 of BLL showing higher risk of CVDs (OR=3.1, 95% CI 0.9 to 10.6; OR=6.5, 95% CI 1.4 to 30.8; OR=5.5, 95% CI 1.4 to 21.7) compared with quartile 1. When stratified by median value of vitamin B6, a significant association between higher CVD risk with higher BLL was only observed in subjects with low vitamin B6 (p trend=0.004).ConclusionsVitamin B6 could modify the association between BLL and CVDs, which suggests a potential value of vitamin B6 in influencing the effects of lead exposure on the cardiovascular system.

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“…In addition, some metals, such as cadmium ( Zhou et al. 2016 ) and lead ( Xu et al. 2017 ), have also been linked to dyslipidemia.…”

Section: Descriptions Of the Kcs Of CV Toxicantsmentioning

confidence: 99%

Key Characteristics of Cardiovascular Toxicants

Lind¹,

Araujo

Barchowsky

et al. 2021

Environ Health Perspect

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Background: The concept of chemical agents having properties that confer potential hazard called key characteristics (KCs) was first developed to identify carcinogenic hazards. Identification of KCs of cardiovascular (CV) toxicants could facilitate the systematic assessment of CV hazards and understanding of assay and data gaps associated with current approaches. Objectives: We sought to develop a consensus-based synthesis of scientific evidence on the KCs of chemical and nonchemical agents known to cause CV toxicity along with methods to measure them. Methods: An expert working group was convened to discuss mechanisms associated with CV toxicity. Results: The group identified 12 KCs of CV toxicants, defined as exogenous agents that adversely interfere with function of the CV system. The KCs were organized into those primarily affecting cardiac tissue (numbers 1–4 below), the vascular system (5–7), or both (8–12), as follows: 1) impairs regulation of cardiac excitability, 2) impairs cardiac contractility and relaxation, 3) induces cardiomyocyte injury and death, 4) induces proliferation of valve stroma, 5) impacts endothelial and vascular function, 6) alters hemostasis, 7) causes dyslipidemia, 8) impairs mitochondrial function, 9) modifies autonomic nervous system activity, 10) induces oxidative stress, 11) causes inflammation, and 12) alters hormone signaling. Discussion: These 12 KCs can be used to help identify pharmaceuticals and environmental pollutants as CV toxicants, as well as to better understand the mechanistic underpinnings of their toxicity. For example, evidence exists that fine particulate matter [PM in aerodynamic diameter ( )] air pollution, arsenic, anthracycline drugs, and other exogenous chemicals possess one or more of the described KCs. In conclusion, the KCs could be used to identify potential CV toxicants and to define a set of test methods to evaluate CV toxicity in a more comprehensive and standardized manner than current approaches. https://doi.org/10.1289/EHP9321

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Associations between lead concentrations and cardiovascular risk factors in U.S. adolescents

Cited by 26 publications

References 24 publications

Association between blood lead level and risk of stroke in Korean adults: a cross-sectional study in the Korea National Health and Nutrition Examination Survey 2008–2013

Association between blood lead level and risk of stroke in Korean adults: a cross-sectional study in the Korea National Health and Nutrition Examination Survey 2008–2013

Modification of vitamin B6 on the associations of blood lead levels and cardiovascular diseases in the US adults

Key Characteristics of Cardiovascular Toxicants

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