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Lead Exposure and Cardiovascular Disease: A Systematic Review

Environmental health perspectives, 2007-03, Vol.115 (3), p.472-482 [Peer Reviewed Journal]

COPYRIGHT 2007 National Institute of Environmental Health Sciences ;COPYRIGHT 2007 National Institute of Environmental Health Sciences ;Copyright National Institute of Environmental Health Sciences Mar 2007 ;2007 ;ISSN: 0091-6765 ;EISSN: 1552-9924 ;DOI: 10.1289/ehp.9785 ;PMID: 17431501

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  • Title:
    Lead Exposure and Cardiovascular Disease: A Systematic Review
  • Author: Navas-Acien, Ana ; Guallar, Eliseo ; Silbergeld, Ellen K. ; Rothenberg, Stephen J.
  • Subjects: Blood ; Blood pressure ; Blood Pressure - drug effects ; Cardiovascular diseases ; Cardiovascular Diseases - chemically induced ; Cardiovascular Diseases - epidemiology ; Complications and side effects ; Electrocardiography ; Environmental Exposure - adverse effects ; Environmental Pollutants - blood ; Environmental Pollutants - toxicity ; Epidemiology ; Heart rate ; Humans ; Hypertension ; Lead ; Lead - blood ; Lead - toxicity ; Lead poisoning ; Mini-Monograph ; Mortality ; Risk factors ; Smelters
  • Is Part Of: Environmental health perspectives, 2007-03, Vol.115 (3), p.472-482
  • Description: Objective: This systematic review evaluates the evidence on the association between lead exposure and cardiovascular end points in human populations. Methods: We reviewed all observational studies from database searches and citations regarding lead and cardiovascular end points. Results: A positive association of lead exposure with blood pressure has been identified in numerous studies in different settings, including prospective studies and in relatively homogeneous socioeconomic status groups. Several studies have identified a dose-response relationship. Although the magnitude of this association is modest, it may be underestimated by measurement error. The hypertensive effects of lead have been confirmed in experimental models. Beyond hypertension, studies in general populations have identified a positive association of lead exposure with clinical cardiovascular outcomes (cardiovascular, coronary heart disease, and stroke mortality; and peripheral arterial disease), but the number of studies is small. In some studies these associations were observed at blood lead levels < 5 µg/dL. Conclusions: We conclude that the evidence is sufficient to infer a causal relationship of lead exposure with hypertension. We conclude that the evidence is suggestive but not sufficient to infer a causal relationship of lead exposure with clinical cardiovascular outcomes. There is also suggestive but insufficient evidence to infer a causal relationship of lead exposure with heart rate variability. Public Health Implications: These findings have immediate public health implications. Current occupational safety standards for blood lead must be lowered and a criterion for screening elevated lead exposure needs to be established in adults. Risk assessment and economic analyses of lead exposure impact must include the cardiovascular effects of lead. Finally, regulatory and public health interventions must be developed and implemented to further prevent and reduce lead exposure.
  • Publisher: United States: National Institute of Environmental Health Sciences. National Institutes of Health. Department of Health, Education and Welfare
  • Language: English
  • Identifier: ISSN: 0091-6765
    EISSN: 1552-9924
    DOI: 10.1289/ehp.9785
    PMID: 17431501
  • Source: U.S. Government Documents
    MEDLINE
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
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