Lead Exposure Is Related to Impairment of Aortic Elasticity Parameters

Abstract

Arterial hypertension is one of the physical complications of chronic lead exposure. Hypertension has effects on aortic elastic properties. The aim of this study was to evaluate the aortic elastic properties in workers occupationally exposed to lead. Forty‐one workers who were exposed to lead and 39 healthy controls were included in the study. All patients underwent transthoracic echocardiography for detecting aortic elastic parameters. There were no differences in baseline characteristics between the lead‐exposure group and controls. Aortic strain (9.4%±4.5% vs 12.4%±4.2%, P=.004) and aortic distensibility (0.45±0.21 cm2/dyn vs 0.55±0.20 cm2/dyn, P=.046) were decreased in patients with lead exposure compared with controls. There was a negative significant weak correlation between aortic strain and (r=−0.294, P=.008) lead levels. There was no significant correlation between aortic distensibility and any other echocardiographic parameters. This study suggests that chronic exposure to lead is related to impairment of aortic elasticity parameters.

Central hemodynamics in relation to low-level environmental lead exposure

“…Previous studies addressed the association of blood pressure [19,40,41] or peripheral arterial disease [42] with environmental exposure to cadmium, as assessed from blood cadmium [40,42], an index of recent exposure [43], or toenail cadmium [19,41], but none assessed central hemodynamics. In a study of 2125 participants enrolled in the 1999-2000 National Health and Nutrition Examination Survey [42], the prevalence of an ankle-brachial index of less than 0.9 in at least one leg increased from 18 [42]. To our knowledge, the association between arterial structure and function was only assessed in people recruited from the catchment area of our current study [44].…”

“…Mean values of the carotid intima-media thickness (1.14 vs. 0.98 mm), local carotid stiffness (12.0 vs. 9.8), augmentation index (26.0 vs. 20.1%) and the one-point pulse wave velocity (7.6 vs. 6.9 m/s) were significantly higher in exposed workers. In a further case-control study of 41 exposed workers (45.4 mg/dL) and 39 healthy controls (1.2 mg/ dL) with mean age of 36.3 years, aortic strain (9.4 vs. 12.4%; p ¼ .004) and aortic distensibility (0.45 vs. 0.55; p ¼ .046) were lower in exposed compared with non-exposed participants [18]. In follow-up study of 25 welders, there was no association between the tonometrically measured augmentation index and the lead concentration in toenails [19].…”

“…Few previous studies addressed the potential association of arterial stiffness with lead exposure [9][10][11][12][13][14][15][16][17][18][19]. Interpretation of these studies is difficult, because most focused on the occupational exposure to lead [15][16][17][18][19], applied a suboptimal method to assess central hemodynamics [15,16], had a small sample size [19], or case-control design [15,17,18]. Four studies, all in an occupational setting, focused on central hemodynamics [16][17][18][19].…”

“…Interpretation of these studies is difficult, because most focused on the occupational exposure to lead [15][16][17][18][19], applied a suboptimal method to assess central hemodynamics [15,16], had a small sample size [19], or case-control design [15,17,18]. Four studies, all in an occupational setting, focused on central hemodynamics [16][17][18][19]. Among 420 male workers driving buses in Bangkok (mean age, 41.6 years) [16], blood lead ranged from 2.5 to 16.2 lg/dL (mean, 6.3 lg/dL).…”

“…Whereas there is an abundant, albeit contradictory, literature on the association of blood pressure with lead exposure, a PubMed search using as keywords "pulse pressure" OR "augmentation index" OR "pulse wave velocity" OR "arterial stiffness" combined with "exposure" or "lead exposure" revealed only ten articles of potential relevance to the research issue addressed in this article. These studies described the association of peripheral pulse pressure [9][10][11][12][13][14], the ambulatory arterial stiffness index [15], or central hemodynamic measurements [16][17][18][19] with the lead concentration in blood [9][10][11][12][13][14][15][16][17][18], urine [15], toenails [19], or bone [10,11,13]. Our objective was to address this knowledge gap.…”