title: Blood pressure in relation to environmental lead exposure in the national health and nutrition examination survey 2003 to 2010.
abstract: In view of the declining environmental lead exposure in the United States, we analyzed the National Health and Nutrition Examination Survey (2003-2010) for association of blood pressure and hypertension with blood lead. The 12 725 participants included 21.1% blacks, 20.5% Hispanics, 58.4% whites, and 48.7% women. Blacks compared with non-Blacks had higher systolic and diastolic pressures (126.5 versus 123.9 and 71.9 versus 69.6 mm Hg) and higher hypertension prevalence (44.7 versus 36.8%). Blood lead was lower in whites than in non-whites (1.46 versus 1.57 μg/dL) and in women than in men (1.25 versus 1.80 μg/dL). In multivariable analyses of all participants, blood lead doubling was associated with higher (P≤0.0007) systolic and diastolic pressure (+0.76 mm Hg; 95% confidence interval, 0.38-1.13 and +0.43 mm Hg; 0.18-0.68), but not with the odds of hypertension (0.95; 0.90-1.01; P=0.11). Associations with blood lead were nonsignificant (P≥0.09) for systolic pressure in women and for diastolic pressure in non-whites. Among men, systolic pressure increased with blood lead (P≤0.060) with effect sizes associated with blood lead doubling ranging from +0.65 mm Hg in whites to +1.61 mm Hg in blacks. For systolic pressure, interactions of ethnicity and sex with blood lead were all significant (P≤0.019). In conclusion, small and inconsistent effect sizes in the associations of blood pressure with blood lead likely exclude current environmental lead exposure as a major hypertension cause in the United States.
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Gu
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Lotte
authors.initials: L
authors.lastname: Jacobs
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Zhang
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Liu
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.).
authors.forename: Tim S
authors.initials: TS
authors.lastname: Nawrot
authors.affiliation: From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (A.H., L.T., Y.-M.G., L.J., Z.-Y.Z., Y.-P.L., J.A.S.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A.); Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium (T.S.N.); and Research and Development Group VitaK, Maastricht University, Maastricht, The Netherlands (J.A.S.). jan.staessen@med.kuleuven.be ja.staessen@maastrichtuniversity.nl.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D007854:Lead / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D007854:Lead
keywords: blood pressure; environmental medicine; hypertension; lead; toxicology