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American Journal of Epidemiology Vol. 131, No. 5: 845-854
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health

research-article

INFLUENCE OF RACE, TOBACCO USE, AND CAFFEINE USE ON THE RELATION BETWEEN BLOOD PRESSURE AND BLOOD LEAD CONCENTRATION

DAN S. SHARP1,2 3, NEAL L. BENOWITZ2,, JOHN D. OSTERLOH2, CHARLES E. BECKER2, ALLAN H. SMITH1 and S. LEONARD SYME1

1 Department of Biomedical and Environmental Health Sciences, School of Public Health, University of California at Berkeley Berkeley, CA
2 Divisions of Clinical Pharmacology and Experimental Therapeutics, and Occupational Medicine, Medical Service, San Francisco General Hospital Medical Center, and Departments of Medicine, Laboratory Medicine, and Psychiatry, University of California, San Francisco San Francisco, CA

Reprint requests to Dr. Neal L. Benowitz, San Francisco General Hospital Medical Center, 1001 Potrero Ave., San Francisco, CA 94110

A number of studies have suggested a small to moderate positive relation between blood pressure and blood lead concentration in males (2–4 mmHg/in(µg/dl)). However, this 1986 study of San Francisco bus drivers suggests larger relations in black males (n=132) for both systolic pressure (7.5 mmHg/in(µg/dl)) and diastolic pressure (4.7 mmHg/in(µg/dl)) at very low blood lead concentrations (2–21 µg/dl). This increase appears to result from negative confounding, particularly after taking into account tobacco use. Relations are even larger in blacks who infrequently use caffeine (16.7 and 10.4 mmHg/in(µg/dl)) for systolic and diastolic pressure, respectively). In contrast, a negative relation between systolic pressure and blood lead concentration (–5.7 mmHg/in(µg/dl)) is suggested in nonblack males (n=117). These findings indicate that race, lead accumulation, and physiologic effects related to caffeine use (e.g., catecholamine effects) may interact to produce marked differences in effect on blood pressure.

blacks; blood pressure; caffeine; catecholamines; lead; tobacco

3Present address: Medical Research Council Epidemiology Unit, 4 Richmond Road, Cardiff CF2 3AS, United Kingdom


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