Affiliation:
1. Environmental Research Center Duke Kunshan University Kunshan China
2. Department of Medicine University of Texas Dell Medical School Austin TX
3. Department of Surgery Brigham and Women’s Hospital Boston MA
4. Harvard T.H. Chan School of Public Health Harvard University Boston MA
5. Nicholas School of the Environment Duke University Durham NC
Abstract
Background
This study aims to explore whether higher blood lead levels (
BLL
) may be associated with failure to control blood pressure and subsequent uncontrolled hypertension.
Methods and Results
We used serial cross‐sectional waves of the
US
National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. 30 762 subjects aged 20 years and above were included. Uncontrolled hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. We estimated odds ratios (
OR
s) of quartiles of
BLL
for any hypertension and uncontrolled hypertension by sex using logistic regression, adjusted for demographics, smoking status, serum cotinine, alcohol intake, body mass index, and menopause status in women. The weighted prevalence of hypertension was 46.7%, of which 80.1% were uncontrolled. Men, younger ages, ethnic minorities, people with lower income, never and current smokers, and people with higher
BLL
were less likely to have their hypertension controlled. In men, compared with the lowest quartile of
BLL
(<0.94 μg/dL), the highest 2 quartiles (0.94–1.50 μg/dL, 1.50–2.30 μg/dL) were associated with hypertension (Q2:
OR
, 1.12; 95%
CI
, 0.96–1.30; Q3:
OR
, 1.16; 95%
CI
, 1.01–1.34; Q4:
OR
, 1.25; 95%
CI
, 1.08–1.45), but not in women. In hypertensive men, higher
BLL
was related to uncontrolled hypertension compared with the lowest quartile (Q2:
OR
, 1.34; 95%
CI
, 0.98–1.85; Q3:
OR
, 1.70; 95%
CI
, 1.26–2.30; Q4:
OR
, 1.96; 95%
CI
, 1.45–2.65). In women, the relationship was similar (Q2:
OR
, 1.26; 95%
CI
, 0.95–1.67; Q3:
OR
, 1.48; 95%
CI
, 1.10–2.00; Q4: 1.70; 95%
CI
, 1.26–2.30).
Conclusions
BLL
is associated with higher prevalence of hypertension and uncontrolled hypertension, with more pronounced association in men.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
48 articles.
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