Association between blood lead levels and stroke: Evidence from a US National Health Survey

Stroke is acknowledged as a principal factor contributing to the overall burden of disability. Nevertheless, there has been little research into the relationship between blood lead concentration (BLC) and stroke. The objective of this study was to assess the potential association between BLC and stroke within the United States. The data from the National Health and Nutrition Examination Survey for the period 2017 to 2018 were collected and subjected to analysis. Stroke cases were identified through the utilization of a question designed to ascertain whether the subject had been informed by a medical practitioner that they had experienced a stroke. A multivariate logistic regression model was employed to calculate the odds ratio (OR) and assess the potential deleterious effects of BLC. The study cohort comprised 5013 individuals with a mean age of 48.47 ± 0.58 years, 48.02% male and 51.98% female. Individuals with elevated BLC levels were more likely to be male (58.17% vs 31.37%, P < .0001), aged over 65 (34.16% vs 4.72%, P < .0001), non-Hispanic White (62.93% vs 59.43%, P < .0001), physically inactive (48.09% vs 44.36%, P = .0175), have a lower income-to-poverty ratio (23.21% vs 21.82% for poverty-income ratio < 1.3, P = .001), and possess a higher body mass index (BMI). After controlling for potential confounding variables, a significant positive association between BLC and stroke was observed (OR: 4.44, 95% confidence interval [CI]: 1.89-10.4, P = .002). The findings suggest that individuals under the age of 65 years (OR: 3.12, 95% CI: 1.51-6.46, P = .005), and females (OR: 2.89, 95% CI: 1.53-5.45, P = .003) were at particularly elevated risk. The elevated risk of stroke observed in individuals with elevated BLC levels was significant across all ethnic groups, with non-Hispanic Blacks showing the strongest association (OR: 5.39, 95% CI: 1.75-16.57, P = .006). The results of this study indicate a positive correlation between BLC and stroke. Furthermore, individuals under the age of 65, females, non-Hispanic Whites, and those with a BMI exceeding 25 kg/m2 were found to be significantly associated with an increased risk of stroke.