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American Journal of Epidemiology Vol. 121, No. 2: 246-258
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health


research-article

THE RELATIONSHIP BETWEEN BLOOD LEAD LEVELS AND BLOOD PRESSURE AND ITS CARDIOVASCULAR RISK IMPLICATIONS

JAMES L. PIRKLE1,, JOEL SCHWARTZ2, J. RICHARD LANDIS3 and WILLIAM R. HARLAN4

1Center for Environmental Health, Centers for Disease Control Atlanta, GA 30333
2Environmental Protection Agency Washington, DC
3University of Michigan School of Public Health Ann Arbor, MI
4University of Michigan School of Medicine Ann Arbor, MI

Reprint requests to Dr. James L. Pirkle

The relationship between blood pressure and blood lead levels in the second National Health and Nutrition Examination Survey (1976–1980) has been examined for white males aged 40–59 years. After adjustment for age, body mass index, nutritional factors, and blood biochemistries in a multiple linear regression model, the relationship of systolic and diastolic blood pressures to blood lead levels was statistically significant (p<0.01). There was no evidence of a threshold blood lead level for this relationship. Although these data alone do not prove a causal relationship between low blood lead levels and blood pressure, the findings are consistent with current epidemiologic and animal studies, indicating that a causal relationship is probable. To examine the potential health risks, the multiple logistic risk factor coefficients from the Pooling Project and Framingham studies were used to predict the impact of the 37% decrease in mean blood lead levels which occurred in adult white males from 1976 to 1980. As a result of this blood lead decrease, the calculations predicted a 4.7% decrease in the incidence of fatal and nonfatal myocardlal infarction over 10 years, a 6.7% decrease in the incidence of fatal and nonfatal strokes over 10 years, and a 5.5% decrease in the incidence of death from all causes over 11.5 years. In addition, as a result of this blood lead decrease, the predicted number of white males in this age group with hypertension (diastolic blood pressure ≥90 mmHg) decreased by 17.5%.

blood pressure; cerebrovascular disorders; lead; myocardial infarction


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