Low-Level Cumulative Lead and Resistant Hypertension: A Prospective Study of Men Participating in the Veterans Affairs Normative Aging Study

Details

• Personal Author:
  Hu H ; Park SK ; Sparrow D ; Vokonas PS ; Weisskopf MG ; Zheutlin AR
• Description:
  Background: Bone lead offers a better method over blood lead measurement to discern long-term lead exposure and accumulation. We examined the risk of resistant hypertension based on bone lead levels in a prospective cohort study of NAS (Normative Aging Study). Methods and Results: Participants had clinic data on hypertension (systolic blood pressure, diastolic blood pressure, and antihypertension medication), lead (blood, bone-patella, bone-tibia), and demographic and confounding variables. Cases of resistant hypertension were identified by meeting criteria for: (1) inadequate systolic blood pressure (>140 mm Hg) or diastolic blood pressure (>90 mm Hg) while taking 3 medications or (2) requiring >4 medications for blood pressure control. A modified Poisson regression was used for model analysis. Of the 475 participants, 97 cases of resistant hypertension (20.4%) were identified. Among the cases of resistant hypertension, the median tibia and patella lead levels were 20 ug/g and 25 ug/g, respectively, while median tibia and patella lead levels were 20 ug/g and 27.5 ug/g, respectively, in participants without resistant hypertension. Tibia lead demonstrated a significant association with resistant hypertension (relative risk, 1.19; 95% confidence interval, 1.01-1.41 [P=0.04]) per interquartile range increase in tibia lead (13-28.5 ug/g). Patella lead was not associated with resistant hypertension (relative risk, 1.10; 95% confidence interval, 0.92-1.31 [P=0.31]) per interquartile range increase in patella lead (18-40 ug/g). Blood lead levels were not significantly associated with resistant hypertension (relative risk, 1.11; 95% confidence interval, 0.88-1.40 [P=0.38]). Conclusions: Tibia lead represents a novel risk factor for resistant hypertension. Our study demonstrates an increased association between tibia lead and resistant hypertension status, with an increased risk of 19% per 1 interquartile range increase in tibia lead. [Description provided by NIOSH]
• Subjects:
  Biomarkers Cardiovascular Diseases Cardiovascular System Lead Occupational Exposure Occupational Health Safety
• Keywords:
  Author Keywords: Environment Biological Monitoring Blood Lead Levels Chronic Exposure Epidemiology High Blood Pressure Hypertension
• ISSN:
  2047-9980
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; Michigan ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 5 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  7
• Issue:
  21
• NIOSHTIC Number:
  nn:20055174
• Citation:
  J Am Heart Assoc 2018 Nov; 7(21):e010014
• Contact Point Address:
  Sung Kyun Park, ScD, MPH, Department of Epidemiology, Department of Environmental Health Sciences, University of Michigan School of Public Health, M5541 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029
• Email:
  sungkyun@umich.edu
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Michigan, Ann Arbor
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of the American Heart Association
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:159bea883978a2b814a3f2d0d428b6a4e925aa5cb046e731fb575b1fd7d7d9bdf1f69b500c12b06ff78f40cf73022088fffc2ba920384f99ea5972056a3b8b8c
• Download URL:
  https://stacks.cdc.gov/view/cdc/217534/cdc_217534_DS1.pdf
• File Type:
  [PDF - 273.18 KB ]