Abstract
BackgroundEnvironmental 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.MethodsA 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.ResultsThe 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).ConclusionAt 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.
Highlights
Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension
In view of the low blood lead concentrations found in our study (1.97 μg/dL) and the divergent results published on literature, we aimed to examine the relationship of blood lead with blood pressure and hypertension in a population-based sample of Brazilian adults living in southern Brazil
Participants currently or former employed in lead industries had higher blood lead levels (2.65 μg/dL; 95% Confidence Intervals (CI), 2.31–3.05) than those not employed (Table 1)
Summary
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 to evaluate associations with adverse health effects. Chronic lead exposure and accumulation in the body can lead to progressive health effects. Among these effects, increased blood pressure, which is associated with the onset of cardiovascular diseases, has been linked to lead exposure. Publications of NHANES (National Health and Nutrition Examination Survey) data have reported a decline of environmental lead exposure in the United States and consequent lower blood lead concentrations in the American population. Recent data have suggested that the effect sizes in the associations of blood pressure and blood lead (mean of 1.51 μg/dL) are small and inconsistent [6], or that a modest association was found [12]
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