title: Changes in systolic blood pressure associated with lead in blood and bone.
abstract: BACKGROUND
  Several studies have examined longitudinal associations of blood pressure change or hypertension incidence with lead concentration in blood or bone. It is not clear whether the observed associations reflect an immediate response to lead as a consequence of recent dose or rather are a persistent effect of cumulative dose over a lifetime.
  
  
  METHODS
  We followed 575 subjects in a lead-exposed occupational cohort in South Korea between October 1997 and June 2001. We used generalized estimating equation models to evaluate blood pressure change between study visits in relation to tibia lead concentrations at each prior visit and concurrent changes in blood lead. The modeling strategy summarized the longitudinal association of blood pressure with cumulative lead dose or changes in recent lead dose.
  
  
  RESULTS
  On average, participants were 41 years old at baseline and had worked 8.5 years in lead-exposed jobs. At baseline, the average +/- standard deviation for blood lead was 31.4 +/- 14.2 microg/dL, and for tibia lead, it was 38.4 +/- 42.9 microg/g bone mineral. Change in systolic blood pressure during the study was associated with concurrent blood lead change, with an average annual increase of 0.9 (95% confidence interval = 0.1 to 1.6) mm Hg for every 10-microg/dL increase in blood lead per year.
  
  
  CONCLUSIONS
  The findings in this relatively young population of current and former lead workers suggest that systolic blood pressure responds to lead dose through acute pathways in addition to the effects of cumulative injury.
authors.affiliation: Office of Research and Development, U.S. Environmental Protection Agency, 1600 Pennsylvania Avenue, Washington, DC 20460, USA. glenn.barbara@epa.gov
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Glenn
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: Byung-Kook
authors.initials: BK
authors.lastname: Lee
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Weaver
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Todd
authors.forename: Brian S
authors.initials: BS
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D007723:Korea / Q000453:epidemiology; D007854:Lead / Q000009:adverse effects* / Q000097:blood / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D014283:Triiodobenzoic Acids / Q000737:chemistry
chemical_list: D014283:Triiodobenzoic Acids; D007854:Lead; C052968:2,3,5-triiodobenzoic acid