Cumulative community-level lead exposure and pulse pressure: the normative aging study.
BACKGROUND
Pulse pressure increases with age in industrialized societies as a manifestation of arterial stiffening. Lead accumulates in the vasculature and is associated with vascular oxidative stress, which can promote functional and structural vascular disease.


OBJECTIVE
We tested the hypothesis that cumulative community-level lead exposure, measured with K-X-ray fluorescence, is associated with pulse pressure in a cohort of adult men.


RESULTS
In a cross-sectional analysis of 593 men not treated with antihypertensive medication, tibia lead was positively associated with pulse pressure (p < 0.001). Adjusting for age, race, diabetes, family history of hypertension, education, waist circumference, alcohol intake, smoking history, height, heart rate, fasting glucose, and total cholesterol-to-HDL ratio, increasing quintiles of tibia lead remained associated with increased pulse pressure (ptrend = 0.02). Men with tibia lead above the median (19.0 microg/g) had, on average, a 4.2-mmHg (95% confidence interval, 1.9-6.5) higher pulse pressure than men with tibia lead level below the median. In contrast, blood lead level was not associated with pulse pressure.


CONCLUSIONS
These data indicate that lead exposure may contribute to the observed increase in pulse pressure that occurs with aging in industrialized societies. Lead accumulation may contribute to arterial aging, perhaps providing mechanistic insight into the observed association of low-level lead exposure with cardiovascular mortality.
Perlstein
Todd
T
Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. tperlstein@partners.org
Weuve
Jennifer
J
Schwartz
Joel
J
Sparrow
David
D
Wright
Robert
R
Litonjua
Augusto
A
Nie
Huiling
H
Hu
Howard
H
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000187:drug effects / Q000502:physiology*; D001794:Blood Pressure / Q000187:drug effects*; D015331:Cohort Studies; D004781:Environmental Exposure; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D018709:Statistics, Nonparametric; D013977:Tibia / Q000737:chemistry
D007854:Lead