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(Hypertension. 2003;42:e9.)
© 2003 American Heart Association, Inc.

Letters to the Editor

Hypertension and Low-Level Lead Exposure: A Scientific Issue or a Matter of Faith?

Study Coordinating Centre, Hypertension Unit, Department of Molecular and Cardiovascular Research, University of Leuven, Leuven, Belgium

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Vupputuri et al¹ analyzed the NHANES III data. They reported that among blacks, a 3.3 µg/dL increment in the blood lead concentration was associated with an increase in systolic pressure averaging 0.82 mm Hg in men and 1.55 mm Hg in women. In contrast, blood pressure was not associated with the blood lead level among white men and women.

We analyzed the same NHANES III database.² In line with Vupputuri’s article, we also found a significant and positive relationship between systolic blood pressure and the blood lead concentration in blacks. On the other hand, our analyses revealed significant and negative associations between diastolic pressure and blood lead in whites. We concluded that, across the NHANES III race and sex strata, the relationship between blood pressure and lead exposure was not consistent and should probably be attributed to residual confounding rather than to causation. Vupputuri et al emphasized the positive results and disregarded alternative interpretation of their findings.

A recent meta-analysis of 31 studies revealed only a weak association between blood pressure and blood lead, which is probably not causal in nature.³ Overall, a twofold increase in the blood lead concentration was associated with a 1.0 mm Hg rise in systolic pressure (95% CI: +0.5 to +1.4; P<0.001) and with a 0.6 mm Hg increase in diastolic pressure (95% CI: +0.4 to +0.8; P<0.001).

Although Vupputuri’s findings were confined to blacks, the authors speculated that reducing the environmental exposure to lead might lead to a population-wide . . . [Full Text of this Article]

Suma Vupputuri

Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina

Vecihi Batuman

Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana

Jiang He

Department of Medicine, Tulane University School of Medicine, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana