Lead exposure and cardiovascular disease - A systematic review

Ana Navas Acien, Eliseo Guallar, Ellen Silbergeld, Stephen J. Rothenberg

Research output: Contribution to journalArticle

Abstract

Objective: This systematic review evaluates the evidence on the association between lead exposure and cardiovascular end points in human populations. Methods: We reviewed all observational studies from database searches and citations regarding lead and cardiovascular end points. Results: A positive association of lead exposure with blood pressure has been identified in numerous studies in different settings, including prospective studies and in relatively homogeneous socioeconomic status groups. Several studies have identified a dose-response relationship. Although the magnitude of this association is modest, it may he underestimated by measurement error. The hypertensive effects of lead have been confirmed in experimental models. Beyond hypertension, studies in general populations have identified a positive association of lead exposure with clinical cardiovascular outcomes (cardiovascular, coronary heart disease, and stroke mortality; and peripheral arterial disease), but the number of studies is small. In some studies these associations were observed at blood lead levels <5 μg/dL. Conclusions: We conclude that the evidence is sufficient to infer a causal relationship of lead exposure with hypertension. We conclude that the evidence is suggestive but not sufficient to infer a causal relationship of lead exposure with clinical cardiovascular outcomes. There is also suggestive but insufficient evidence to infer a causal relationship of lead exposure with heart rate variability. Public Health Implications: These findings have immediate public health implications. Current occupational safety standards for blood lead must be lowered and a criterion for screening elevated lead exposure needs to be established in adults. Risk assessment and economic analyses of lead exposure impact must include the cardiovascular effects of lead. Finally, regulatory and public health interventions must be developed and implemented to further prevent and reduce lead exposure.

Original languageEnglish (US)
Pages (from-to)472-482
Number of pages11
JournalEnvironmental Health Perspectives
Volume115
Issue number3
DOIs
StatePublished - Mar 2007

Fingerprint

cardiovascular disease
Cardiovascular Diseases
Public health
public health
hypertension
Public Health
blood
exposure
Lead
Blood
Hypertension
socioeconomic status
dose-response relationship
Peripheral Arterial Disease
Blood pressure
Occupational Health
Measurement errors
Social Class
Risk assessment
Population

Keywords

  • Atherosclerosis
  • Blood pressure
  • Cardiovascular disease
  • Heart rate variability
  • Hypertension
  • Lead
  • Systematic review

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

Lead exposure and cardiovascular disease - A systematic review. / Navas Acien, Ana; Guallar, Eliseo; Silbergeld, Ellen; Rothenberg, Stephen J.

In: Environmental Health Perspectives, Vol. 115, No. 3, 03.2007, p. 472-482.

Research output: Contribution to journalArticle

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