Apostoli P, Corulli A, Metra M, Dei Cas L
Cattedra di Igiene Industriale, Università degli Studi di Brescia, P.le Spedali Civili 1, 25123 Brescia.
Med Lav. 2004 Mar-Apr;95(2):124-32.
The studies dealing with the relationship between cardiovascular disease and exposure to environmental and occupational chemical risks are out-dated and insufficient. However, this is not true of studies on lead.
This paper aims to investigate in particular the etiopathogenesis of the relationship between lead exposure and hypertension.
The studies published in the last decade concerning both the general population and occupationally exposed subjects were reviewed.
The effects due to high levels of exposure to lead are well known and have been studied for over a century. Knowledge on the chronic effects deriving from low and long-term exposure is still very controversial but is currently the most interesting topic; in particular lead hypertension is the topic of an increasing number of studies. Chronic exposure to low levels of lead can cause hypertension via several mechanisms. The most important are: oxidative stress associated with functional NO deficiency, elevation of sympathetic activity coupled with depressed vascular and increased renal beta receptor densities, activation of the renin-angiotensin-aldosterone system, rise in endothelin production, reduction in vasodilatatory prostaglandins and elevation of vasoconstrictive prostaglandins.
有关心血管疾病与暴露于环境及职业化学风险之间关系的研究已过时且不充分。然而,关于铅的研究并非如此。
本文旨在特别研究铅暴露与高血压之间关系的病因发病机制。
回顾了过去十年中发表的有关普通人群和职业暴露人群的研究。
高铅暴露的影响众所周知,且已研究了一个多世纪。关于低水平长期暴露产生的慢性影响的知识仍极具争议,但目前是最受关注的话题;尤其是铅性高血压是越来越多研究的主题。长期低水平铅暴露可通过多种机制导致高血压。最重要的机制有:与功能性一氧化氮缺乏相关的氧化应激、交感神经活动增强伴血管功能减退和肾β受体密度增加、肾素 - 血管紧张素 - 醛固酮系统激活、内皮素生成增加、血管舒张性前列腺素减少以及血管收缩性前列腺素增加。