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Bone lead levels and blood pressure endpoints: a meta-analysis
Ana Navas-Acien1, Brian S Schwartz, Stephen J Rothenberg
1Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA. anavas@jhsph.edu
Epidemiology (Cambridge, Mass.)
|April 17, 2008
Summary
This meta-analysis found small associations between tibia bone lead levels and increased systolic blood pressure and hypertension risk. Further research with individual participant data is needed for a comprehensive understanding of bone lead
Area of Science:
- Environmental Health
- Epidemiology
- Toxicology
Background:
- Previous research indicates a link between elevated blood lead levels and increased blood pressure and hypertension.
- This study focuses on the association between bone lead levels and cardiovascular outcomes.
Purpose of the Study:
- To conduct a meta-analysis examining the relationship between bone lead levels (tibia and patella) and blood pressure (systolic and diastolic) and hypertension.
- To synthesize findings from published epidemiologic studies.
Main Methods:
- Searched Medline, Embase, and Toxline databases for relevant epidemiologic studies.
- Employed inverse-variance weighted random-effects models to analyze data on tibia or patella lead levels and blood pressure endpoints.
Main Results:
- Summarized data from 3 prospective and 5 cross-sectional studies, all measuring tibia lead and 3 measuring patella lead.
- A 10 microg/g increase in tibia lead was associated with a 0.26 mm Hg increase in systolic blood pressure (CI: 0.02 to 0.50) and an odds ratio of 1.04 for hypertension (CI: 1.01 to 1.07).
- A 10 microg/g increase in patella lead showed an odds ratio of 1.04 for hypertension (CI: 0.96 to 1.12).
Conclusions:
- Systolic blood pressure and hypertension risk showed an association with tibia bone lead levels, though the effect size was small.
- Limitations include reliance on published data, preventing evaluation of nonlinear dose-response, bone vs. blood lead contributions, and population differences.
- A pooled analysis of individual participant data is recommended for a more thorough characterization of bone lead's impact on blood pressure.
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