title: Association between blood lead and blood pressure: a population-based study in Brazilian adults.
abstract: Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil.
  
  
  
  A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP.
  
  
  
  The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46).
  
  
  
  At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead exposure monitoring and the enactment of regulatory laws to prevent lead contamination in urban settings.
authors.affiliation: Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.
authors.forename: Ana Carolina Bertin de
authors.initials: ACB
authors.lastname: Almeida Lopes
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Ellen Kovner
authors.initials: EK
authors.lastname: Silbergeld
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Zamoiski
authors.affiliation: Graduate Program in Toxicology, Faculty of Pharmaceutical Sciences of University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Airton da Cunha
authors.initials: ADC
authors.lastname: Martins
authors.affiliation: Graduate Program in Health Sciences, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.
authors.forename: Alissana Ester Iakmiu
authors.initials: AEI
authors.lastname: Camargo
authors.affiliation: Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.|Department of Statistics, State University of Londrina - UEL, Londrina, Paraná, Brazil.
authors.forename: Mariana Ragassi
authors.initials: MR
authors.lastname: Urbano
authors.affiliation: Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil.|Department of Public Health, State University of Londrina - UEL, Londrina, Paraná, Brazil.
authors.forename: Arthur Eumann
authors.initials: AE
authors.lastname: Mesas
authors.affiliation: Graduate Program in Public Health, Center of Health Sciences, State University of Londrina - UEL, Londrina, Paraná, Brazil. monibas2@gmail.com.|Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA. monibas2@gmail.com.
authors.forename: Monica Maria Bastos
authors.initials: MMB
authors.lastname: Paoliello
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001938:Brazil / Q000453:epidemiology; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D007854:Lead / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio
chemical_list: D004785:Environmental Pollutants; D007854:Lead
keywords: Blood lead; Blood pressure; Hypertension; Population-based