Contribution of Lead to Hypertension with Renal Impairment

Abstract

Hypertension of unknown cause is generally termed "essential." Because hypertension has long been considered a possible complication of lead poisoning and the EDTA lead-mobilization test has proved to be a sensitive indicator of excessive body stores of lead, we used this test to evaluate cumulative past lead absorption in 48 men diagnosed as having essential hypertension. Patients who had hypertension with reduced renal function (i.e., serum creatinine level greater than 1.5 mg per deciliter [133 mumols per liter]) had significantly larger amounts of mobilizable lead than did patients who had hypertension without renal impairment. The increase in mobilizable lead was not due to the renal disease itself, since 22 control patients without a history of essential hypertension but with comparable renal impairment from known causes excreted significantly less lead chelate during the three-day test. These data suggest that lead may have an etiologic role in the renal disease of some patients usually designated as having "essential" hypertension.

Blood Lead Level and Blood Pressure of Bus Drivers in Bangkok, Thailand

“…This may be a result of higher lead exposure. The results are similar to several studies that reported lead exposure induces hypertension 6,11,[20][21][22] . In the present study, the supine position was employed for measuring blood pressure, which may make the blood pressure measurements different from those taken in sitting position employed in other studies.…”

Clinical Evaluation of a Lead Mobilization Test Using the Chelating Agent Dimercaptosuccinic Acid

“…To determine whether there is an increased mobilizable lead pool, the size of the chelatable pool in controls must first be measured. A CaNa 2 EDTA LMT considered to be positive covers chelated-PbU amounts of 350-1000 g/24 h, with ϳ600 g/ 24 h being the most generally used limit (16,21,25,(63)(64)(65)(66)(67)(68). The importance of a "positive" result, however, is not always clear; possible interpretations include an increased bioavailable lead pool compared with controls, a limit that can be used to distinguish occupationally exposed individuals from persons with no such exposure, a safe limit, an indication for chelation treatment, or identification of individuals who will respond to chelation treatment.…”

Lead, Diabetes, Hypertension, and Renal Function: The Normative Aging Study

“…Studies of lead body burden estimated by EDTA mobilization tests have revealed a correlation of high body lead burden with declines in renal function (Batuman et al 1983;Lin and Huang 1994;Lin et al 2001). There have been a few studies of the association between body burden in the form of bone lead and renal function, but the results have been inconclusive.…”