Blood Lead, Blood Pressure, and Hypertension in Perimenopausal and Postmenopausal Women

Abstract

ContextLead exposures have been shown to be associated with increased blood pressure and risk of hypertension in older men. In perimenopausal women, skeletal lead stores are an important source of endogenous lead exposure due to increased bone demineralization.ObjectiveTo examine the relationship of blood lead level with blood pressure and hypertension prevalence in a population-based sample of perimenopausal and postmenopausal women in the United States.Design, Setting, and ParticipantsCross-sectional sample of 2165 women aged 40 to 59 years, who participated in a household interview and physical examination, from the Third National Health and Nutrition Examination Survey conducted from 1988 to 1994.Main Outcome MeasuresAssociations of blood lead with blood pressure and hypertension, with age, race and ethnicity, cigarette smoking status, body mass index, alcohol use, and kidney function as covariates.ResultsA change in blood lead levels from the lowest (quartile 1: range, 0.5-1.6 µg/dL) to the highest (quartile 4: range, 4.0-31.1 µg/dL) was associated with small statistically significant adjusted changes in systolic and diastolic blood pressures. Women in quartile 4 had increased risks of diastolic (>90 mm Hg) hypertension (adjusted odds ratio [OR], 3.4; 95% confidence interval [CI], 1.3-8.7), as well as moderately increased risks for general hypertension (adjusted OR, 1.4; 95% CI, 0.92-2.0) and systolic (>140 mm Hg) hypertension (adjusted OR, 1.5; 95% CI, 0.72-3.2). This association was strongest in postmenopausal women, in whom adjusted ORs for diastolic hypertension increased with increasing quartile of blood lead level compared with quartile 1 (adjusted OR, 4.6; 95% CI, 1.1-19.2 for quartile 2; adjusted OR, 5.9; 95% CI, 1.5-23.1 for quartile 3; adjusted OR, 8.1; 95% CI, 2.6-24.7 for quartile 4).ConclusionsAt levels well below the current US occupational exposure limit guidelines (40 µg/dL), blood lead level is positively associated with both systolic and diastolic blood pressure and risks of both systolic and diastolic hypertension among women aged 40 to 59 years. The relationship between blood lead level and systolic and diastolic hypertension is most pronounced in postmenopausal women. These results provide support for continued efforts to reduce lead levels in the general population, especially women.

Estimating perchlorate exposure from food and tap water based on US biomonitoring and occurrence data

“…Results of studies of adults with either occupational or environmental lead exposure have shown consistent associations between increased BLLs and increased blood pressure (Nash et al, 2003;Schwartz, 1995;Staessen et al, 1995) and associations between increased bone lead concentrations and blood pressure Korrick et al, 1999). High dose occupational lead exposure, usually with BLLs greater than 40 mg/dL, may alter sperm morphology, reduce sperm count, and decrease fertility (Alexander et al, 1996;Telisman et al, 2000).…”

“…BLLs and associated toxic effects differ in children and adults. For instance, BLLs near 10 µg/dL can affect blood pressure in adults and neurodevelopment in children (Bellinger, 2004;CDC, 1991;Nash et al, 2003;Schwartz, 1995;Staessen et al, 1995). In 1991, based on prospective population studies, the Centers for Disease Control and Prevention (CDC) established a BLL of 10…”

Teratogen update: Lead and pregnancy

“…Although many studies have explored the association between higher lead burdens and hypertension in adult males (Nawrot et al, 2002) and, to a lesser extent, adult females (Nash et al, 2003), few have focused specifically on hypertension during pregnancy. An early report suggested such a link (Rabinowitz et al, 1987), although in that study umbilical cord blood lead level was the sole exposure biomarker measured, and pregnancy hypertension was identified using obstetrical records rather than by direct measurement of blood pressure or assessment of clinical status.…”

Relationship Between Blood Lead Level and Elevated Blood Pressure in Hypertensive Patients: Implication of Nitric Oxide

“…Vupputuri et al, [22] showed that significant associations between blood lead level and systolic and diastolic blood pressures in black men. Nash et al, [17] found that B-Pb level is positively associated with both systolic and diastolic blood pressure in postmenopausal women. Recently, Kasperczyk et al, [29] found that B-Pb levels were positively correlated with high arterial blood pressure (both systolic and diastolic).…”

“…We used the mean of three systolic and diastolic blood pressure measurements, all of which were taken by a physician in the Clinical Unit of Qassim University. Patients were categorized as hypertensive if any of the following criteria were met: current user of blood pressure medication (self-report), a systolic blood pressure of 140 mm Hg or higher, or a diastolic blood pressure of 90 mm Hg or higher [17].…”