Lead Levels and Ischemic Heart Disease in a Prospective Study of Middle-Aged and Elderly Men: the VA Normative Aging Study

Abstract

BackgroundLead exposure has been associated with higher blood pressure, hypertension, electrocardiogram abnormalities, and increased mortality from circulatory causes.ObjectiveWe assessed the association between bone lead—a more accurate biomarker of chronic lead exposure than blood lead—and risk for future ischemic heart disease (IHD).MethodsIn a prospective cohort study (VA Normative Aging Study), 837 men who underwent blood or bone lead measurements at baseline were followed-up for an ischemic heart disease event between 1 September 1991 and 31 December 2001. IHD was defined as either a diagnosis of myocardial infarction or angina pectoris that was confirmed by a cardiologist. Events of fatal myocardial infarction were assessed from death certificates.ResultsAn IHD event occurred in 83 cases (70 nonfatal and 13 fatal). The mean blood, tibia, and patella lead levels were higher in IHD cases than in noncases. In multivariate Cox-proportional hazards models, one standard deviation increase in blood lead level was associated with a 1.27 (95% confidence interval, 1.01–1.59) fold greater risk for ischemic heart disease. Similarly, a one standard deviation increase in patella and tibia lead levels was associated with greater risk for IHD (hazard ratio for patella lead = 1.29; 95% confidence interval, 1.02–1.62).ConclusionsMen with increased blood and bone lead levels were at increased risk for future IHD. Although the pathogenesis of IHD is multifactorial, lead exposure may be one of the risk factors.

Urinary heavy metals and associated medical conditions in the US adult population

“…An association between lead and angina pectoris has been consistently reported by many authors. The possible mechanisms are very similar to the effect of cadmium in promoting atherosclerosis (induction of reactive oxygen species and lipid peroxidation, glutathione depletion and disruption of sulfhydryl homeostasis) (Oneglia et al 1998;Jain et al 2007;Tubek et al 2010). We did find positive associations between higher levels of cadmium and myocardial infarction and stroke.…”

Association of lead and cadmium exposure with frailty in US older adults

“…Second, exposure to lead and cadmium has been related to a higher risk of several pathologic conditions that are also linked to frailty. Environmental exposure to lead in the elderly has been associated with cognitive decline (Bandeen-Roche et al 2009;Grashow et al 2013;Nordberg et al 2000;Power et al 2014;Shih et al 2006;van Wijngaarden et al 2011), impaired motor skills (Grashow et al 2013), increased blood pressure (Perlstein et al 2007), ischemic heart disease (Jain et al 2007), decreased renal function (Tsaih et al 2004), falls and fractures in women (Khalil et al 2008), hearing loss (Park et al 2010) and vision problems (Schaumberg et al 2004;Wu et al 2014). Cadmium, for which fewer studies have been conducted in the elderly, has also been associated with an increased risk of atherosclerotic plaques (Fagerberg et al 2012), peripheral artery disease (Tellez-Plaza et al 2013a), osteoporosis (Engstrom et al 2011;Gallagher et al 2008) and macular degeneration (Shiue 2013;Wu et al 2014).…”

Environmental factors in cardiovascular disease

“…226 Baseline levels of lead in bone are associated with the incidence of and mortality from coronary disease. 227,228 In cross-sectional analyses, blood lead levels were associated with peripheral arterial disease, after adjustment for demographic and cardiovascular risk factors. 229,230 In one study, 229 comparing the highest quartile of blood lead (≥2.47 μg/dl) with the lowest quartile (<1.06 μg/dl), the relative risk for peripheral arterial disease was 1.92 (95% CI 1.02-3.61).…”