Vupputuri Suma, He Jiang, Muntner Paul, Bazzano Lydia A, Whelton Paul K, Batuman Vecihi
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Hypertension. 2003 Mar;41(3):463-8. doi: 10.1161/01.HYP.0000055015.39788.29. Epub 2003 Feb 3.
Chronic lead exposure has been associated with elevated blood pressure in epidemiological studies. It is not known whether the previously observed relation between blood lead and hypertension persists after significant reductions have been made in environmental lead contamination. We examined the relation between blood lead levels and blood pressure in a representative sample of 14 952 whites and blacks aged 18 years or older who participated in the Third National Health and Nutrition Examination Survey. Blood lead was measured by atomic absorption spectrophotometry and blood pressure by standard sphygmomanometry. Mean blood lead levels were significantly higher for black men and women (5.4 and 3.4 microg/dL, respectively) compared with white men and women (4.4 and 3.0 microg/dL, respectively). After multivariate adjustment for important covariables, each standard deviation higher blood lead (3.3 microg/dL) was associated with a 0.82 (95% confidence interval [CI], 0.19 to 1.44) mm Hg and a 1.55 (95% CI, 0.47 to 2.64) mm Hg higher systolic blood pressure among black men and women, respectively. In contrast, blood lead level was not associated with blood pressure among white men or women. The multivariate-adjusted odds ratio (95% CI) of hypertension associated with a 1-SD higher level of blood lead was 1.08 (95% CI, 0.99 to 1.19) for black men and 1.39 (95% CI, 1.21 to 1.61) for black women. These findings suggest that increased levels of blood lead remain an important environmental risk factor for elevated blood pressure in blacks.
在流行病学研究中，慢性铅暴露与血压升高有关。目前尚不清楚在环境铅污染大幅减少之后，之前观察到的血铅与高血压之间的关系是否依然存在。我们在参加第三次全国健康和营养检查调查的14952名18岁及以上的白人和黑人代表性样本中，研究了血铅水平与血压之间的关系。血铅通过原子吸收分光光度法测量，血压通过标准血压计测量。黑人男性和女性的平均血铅水平（分别为5.4和3.4微克/分升）显著高于白人男性和女性（分别为4.4和3.0微克/分升）。在对重要协变量进行多变量调整后，血铅每升高一个标准差（3.3微克/分升），黑人男性和女性的收缩压分别升高0.82（95%置信区间[CI]，0.19至1.44）毫米汞柱和1.55（95%CI，0.47至2.64）毫米汞柱。相比之下，白人男性或女性的血铅水平与血压无关。血铅水平每升高一个标准差，黑人男性高血压的多变量调整优势比（95%CI）为1.08（95%CI，0.99至1.19），黑人女性为1.39（95%CI，1.21至1.61）。这些发现表明，血铅水平升高仍然是黑人血压升高的一个重要环境危险因素。
