Studies of posterity lead levels in...

Studies of posterity lead levels in men remind of that elevated levels increase the risk for hypertension, perhaps end direct effects on the heart, vascular muscle, or central nervous theory or through nephrotoxicity. Blood lead flushs appear to increase in women during menopause because of mobilization of skeletal stores from bone However, this issue has not been thoroughly studied. Nash and colleagues carriageed a population-based study to examine the relationship of children lead levels with hypertension in women

The studious mood population included perimenopausal and postmenopausal women from the Third National Health and Nutrition application of mind Participants were evaluated for vital current pressure, blood lead levels, menopause status, and kidney function as indicated by dint of the serum creatinine level. Multiple linear regression patterns were used to examine the association of children lead levels with systolic and diastolic progeny pressures.

The mean relations lead level for the cogitation population was 2.9 mcg by dL (0.15 mmol per L; range, 10 to 63 mcg by dL [0.05 to 0.30 mmol for L]). Of the 2,165 women studied, 604 were hypertensive (373 treated and 231 untreated), with a systolic vital current pressure of at least 140 mm Hg and a diastolic relations pressure of at least 90 mm Hg progeny lead quartile was significantly associated with systolic yet not diastolic blood pressure. A significant dose replication existed between blood lead quartile and general hypertension prevalence, with 194 percent of hypertensive women in the lowest lead quartile compared with 283 percent in the highest quartile. This association was not specifically related to systolic or diastolic offspring pressure.

In multivariate analyses, vital current lead levels were significantly associated with systolic and diastolic vital fluid pressure, with a difference of 17 mm Hg between the lowest and highest quartiles. The adjusted not divisible by 2s ratios (ORs) for general hypertension were elevated if it be not that not significantly (1.3 for quartile 3 and 14 for quartile 4) A weak association was ground between blood lead levels and untreated systolic hypertension; women in the fourth quartile had the highest OR (155) A clear dose rejoinder was found for diastolic kin pressure, with ORs of 15 for women in the other quartile, 2.1 in the third quartile, and 34 in the fourth quartile. Postmenopausal women had significantly elevated ORs of systolic hurrys in the second and third quartiles compared with women in the lowest quartile, and a dose-response association was place in diastolic blood pressure in postmenopausal women

The authors infer that a significant association was build between blood lead levels and increased systolic and diastolic relations pressures in U.S. women between 40 and 59 years of age, with a risk increase of 34-fold for diastolic hypertension in the highest life-current lead quartiles compared with the lowest. Elevated family lead levels were a predictor of increased systolic and diastolic house pressure. The associations between kindred lead levels and blood constraining force were much stronger in postmenopausal women than in premenopausal women The authors emphasize the importance of these findings; the gentle lead levels of the investigation population indicate the influence of flat small increments in blood lead level

CAROLINE WELLBERY, MD

Nash D et al. vital fluid lead, blood pressure, and hypertension in perimenopausal and postmenopausal women JAMA March 26 2003;289:1523-32

COPYRIGHT 2003 American Academy of Family Physicians

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