Does low lead exposure affect blood pressure and hypertension?

Historically, little was known about the effects of low blood lead level (BLL < 10 μg/dL) on hypertension (HTN). The purpose of this study was to assess the effects of low BLL on blood pressure (BP) and HTN in lead-exposed male workers in the Republic of Korea.

From the year 2000 to 2004, 12,060 male workers underwent an Annual Specialised Medical Check-up for lead; 7,341 subjects had a peak BLL < 10 μg/dL and were selected for the study. The quartiles of peak BLL in lead-exposed workers were as follows: first (0.01-3.68 μg/dL), second (3.69-5.19 μg/dL), third (5.20-6.86 μg/dL), and fourth (6.87-10.00 μg/dL). To examine the relationship between BLL and pre-HTN (systolic BP [SBP] ≥120-140 mmHg; diastolic BP [DBP] ≥80-90 mmHg) and between BLL and HTN (SBP ≥ 140 mmHg; DBP ≥ 90 mmHg), the quartiles of BLL were used as independent variables in multiple logistic regression analysis.

In multiple linear regression analyses, SBP (β 0.04, P < .01) and DBP (β 0.06, P < .01) increased in line with a 1 μg/dL increase in BLL. The odds ratio (OR) of HTN in the fourth versus first BLL quartile (1.54; 95% confidence interval [CI]: 1.26, 1.89) was statistically significant.

SBP and DBP were statistically significantly associated with peak BLL. A BLL ≥ 6.87 μg/dL was associated with HTN; thus, even in workers with low BLLs (<10 μg/dL), management of BP is likely to be necessary. Modulation of the current safety standards for BLLs in workers will be needed.