Is lead considered as a risk factor for high blood pressure during menopause period among Saudi women?

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort

BACKGROUND

Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce.

OBJECTIVES

Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrations and the prevalence of atherosclerotic plaque in the carotid artery.

METHODS

We used cross-sectional data from the Malmö Diet and Cancer Study cardiovascular cohort (MDCS-CC; recruitment in 1991-1994) covering 4,172 middle-aged men and women. B-Pb at baseline, measured by inductively coupled plasma mass spectrometry, was used as the exposure biomarker. The presence of atherosclerotic plaque in the carotid artery was determined by B-mode ultrasonography. We used logistic regression to estimate odds ratios (ORs) for prevalence of plaque in the carotid artery according to B-Pb quartiles.

RESULTS

The median B-Pb was 25μg/L (range: 1.5-258), and 36% of the cohort had any atherosclerotic plaque. After controlling for confounders and known cardiovascular risk factors, the OR for prevalence of plaque in the highest quartile (Q4) of B-Pb compared with the lowest quartile (Q1) was 1.35 (95% CI: 1.09, 1.66) in the total group, 1.58 (95% CI: 1.20, 2.08) among women, and 1.18 (95% CI: 0.83, 1.69) among men. Among women, associations were limited to those who were postmenopausal [OR for Q4 vs. Q1=1.72 (95% CI: 1.26, 2.34) vs. OR=0.96 (95% CI: 0.49, 1.89 in premenopausal women)]. Associations were weak and nonsignificant in never-smokers [OR for Q4 vs. Q1=1.14 (95% CI: 0.81, 1.61)].

DISCUSSION

Our study shows an association between B-Pb concentrations and occurrence of atherosclerotic plaque in the carotid artery, adding evidence for an underlying pro-atherogenic role of lead in cardiovascular disease. Associations appeared to be limited to postmenopausal (vs. premenopausal) women. https://doi.org/10.1289/EHP5057.

Association of Blood Pressure with Exposure to Lead and Cadmium: Analysis of Data from the 2008-2013 Korean National Health and Nutrition Examination Survey

We examined the association of blood pressure with blood levels of cadmium, lead, and their combination in a representative sample of adults from South Korea (Korean National Health and Nutrition Examination Survey, 2008-2013). This cross-sectional study enrolled subjects who were at least 19 years-old, completed a health examination survey, and had blood measurements of lead and cadmium. We estimated the adjusted mean differences in diastolic and systolic blood pressure associated with doubling of blood lead and cadmium by regression of blood pressure against log₂-transformed blood metals and their tertiles after covariate adjustment. Adjusted odds ratios for hypertension and prehypertension were calculated for log₂-transformed blood levels of lead and cadmium and their tertiles. In the general population of Korea, blood lead level was associated with increased BP and risk of hypertension. Blood cadmium levels had a stronger association with elevated blood pressure and risk of hypertension than blood lead levels, and these associations remained significant after statistical adjustment for blood lead. The combination of blood lead and cadmium was more strongly associated with elevated blood pressure than exposure to each individual metal. In females, there was a stronger relationship between blood pressure and blood levels of these metals by analyzing interaction model. After adjustment for confounding factors, there were significant associations of blood pressure with the level of blood lead, cadmium, and their combination in adults from South Korea.

Gender differences for associations between circulating levels of metals and coronary risk in the elderly

Several studies have pointed out associations between various metals and cardiovascular disease. Since cardiovascular disease prevalence is different between males and females, we investigated whether circulating levels of metals related differently to coronary risk in men and women. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, coronary risk was assessed by the Framingham Risk Score together with circulating blood levels of 11 different trace and heavy metals in 1016 subjects aged 70 years. Circulating levels of cadmium, copper and manganese were significantly higher in women than in men, while mercury, zinc and lead were significantly lower following adjustment for kidney function (measured by glomerular filtration rate, GFR). No significant differences between women and men were seen regarding levels of aluminium, molybdenum, cobalt, chromium and nickel. When all 11 metals were entered as independent variables together with GFR in multiple models in the Framingham Risk Score as the dependent variable, cadmium was the major determinant of the Framingham Risk Score in women (p<0.0001, followed by zinc p=0.03), while copper was the major determinant of the Framingham Risk Score in men (p<0.0001, followed by inverse relations vs. aluminium p=0.01 and nickel p=0.01). There are gender differences in levels of metals and also regarding the association between metals and coronary risk, with cadmium levels being most important for women and copper levels for men in this elderly population.

Cloud point extraction for determination of lead in blood samples of children, using different ligands prior to analysis by flame atomic absorption spectrometry: a multivariate study

The phase-separation phenomenon of non-ionic surfactants occurring in aqueous solution was used for the extraction of lead (Pb(2+)) from digested blood samples after simultaneous complexation with ammonium pyrrolidinedithiocarbamate (APDC) and diethyldithiocarbamate (DDTC) separately. The complexed analyte was quantitatively extracted with octylphenoxypolyethoxyethanol (Triton X-114). The multivariate strategy was applied to estimate the optimum values of experimental factors. Acidic ethanol was added to the surfactant-rich phase prior to its analysis by flame atomic absorption spectrometer (FAAS). The detection limit value of Pb(2+) for the preconcentration of 10 mL of acid digested blood sample was 1.14 μg L(-1). The accuracy of the proposed methods was assessed by analyzing certified reference material (whole blood). Under the optimized conditions of both CPE methods, 10 mL of Pb(2+) standards (10 μg L(-1)) complexed with APDC and DDTC, permitted the enhancement factors of 56 and 42, respectively. The proposed method was used for determination of Pb(2+) in blood samples of children with kidney disorders and healthy controls.

Exposure to heavy metals (lead, cadmium and mercury) and its effect on the outcome of in-vitro fertilization treatment

We investigated the effect of lead, cadmium and mercury exposure on pregnancy and fertilization rate outcome among 619 Saudi women (age 19-50 years) who sought in-vitro fertilization (IVF) treatment between 2002 and 2003. The concentrations of lead, cadmium and mercury were measured in both blood and follicular fluids. At levels well below the current US occupational exposure limit guidelines (40microg/dL) and even less than the current Centers for Disease Control and Prevention level of concern for preventing lead poisoning in children (10microg/dL), blood lead level was negatively associated with fertilization outcome in both adjusted and unadjusted logistic regression models. We found that among various demographic, socioeconomic and environmental factors, fish consumption was positively associated with blood lead levels. These results support the hypothesis that a raised blood lead level affects infertility and intervention to reduce the lead exposure might be needed for women of reproductive age. The present results also revealed unexpected finding - the positive relationship between follicular cadmium levels and fertilization outcome, which points to the necessity for further investigation. Though adverse effect of mercury on pregnancy outcome or fertilization rate was not evident in this study, mercury5.8microg/L (EPA safety limit) was found in the blood and follicular fluid of 18.7% and 8.3% of the women, respectively. Concerns about its possible adverse effects on the physiology of reproduction or fetal development cannot be ruled out. It should be noted that skin-lightening creams and dental amalgam were important contributors to mercury exposure. Such finding is alarming and priority for further studies are, urgently, needed.

Blood lead levels among police officers in Lima and Callao, 2004

Lead contamination is a public health problem of world-wide scope that negatively affects the health of especially women and children. Nevertheless, studies on lead contamination and its impact on health in Peru are limited. The objective of the present study was to determine blood lead levels (BLL) of traffic police officers in Lima and Callao compared with values in police officers working indoors and with data obtained in 1992. The study was performed in May-June 2004 and included 52 traffic officers and 50 officers working in police stations in the north, center and east of Lima and Callao, Peru. Both groups were of similar age. The dependent variables were arterial blood pressure and BLL obtained in each officer. In addition a questionnaire was applied to evaluate risk factors for lead exposure. In 2004, the average BLL in traffic police officers was higher (44.7+/-6.1microg/l) than that of indoor police officers (39.3+/-8.2microg/l) (p=0.0001). However, none of the police officers had BLL of over 100microg/l. No differences were observed in the location of the residences of the participants and the respective traffic density. Those over 30 years of age had a higher risk of having a BLL over 42microg/l than younger officers (odds ratio (OR)=4.45). Traffic police officers had a higher risk of BLL >42microg/l (OR=4.80). Compared with data from 1992 obtained from the literature, an important reduction has been observed in 2004. This may be a consequence of the policy to eliminate leaded gasoline in Peru. However, it is still necessary to monitor this policy to ensure the elimination of lead in gasoline.