한국환경보건학회지 (Journal of Environmental Health Sciences)

  • 제37권6호
  • /
  • Pages.418-428
  • /
  • 2011
  • /
  • 1738-4087(pISSN)
  • /
  • 2233-8616(eISSN)
한국환경보건학회 (Korean Society of Environmental Health)
권호 표지
DOI QR코드

DOI QR Code

40세 이상의 한국성인의 혈중 납 농도와 고혈압 - 2008년 국민건강영양조사를 바탕으로 -

Blood Lead Concentration and Hypertension in Korean Adults Aged 40 and Over According to KNHANES IV (2008)

  • 김선영 (진주보건대학교 보건행정과) ;
  • 이덕희 (경북대학교 의과대학 예방의학교실)
  • Kim, Sun-Young (Department of Healthcare Administration, Jinju Health College) ;
  • Lee, Duk-Hee (Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University)
  • 투고 : 2011.11.10
  • 심사 : 2011.12.15
  • 발행 : 2011.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: The purpose of this study was to examine the cross-sectional relationship between low blood lead levels and increasing blood pressure among Korean adults using a nationally representative sample of the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. Methods: A total of 918 subjects aged 40 and older and not currently being treated for hypertension participated in this study. Information about age, gender, smoking status, alcohol consumption, education level, and the use of anti-hypertensive medication was collected. The blood pressure was defined as the mean of the second and the third measurements after three time measurements. Lead levels were determined by an analysis of blood samples. Multiple linear and logistic regression analyses were implemented after adjusting for covariates including age, gender, educational level, smoking status, alcohol consumption, and BMI. Results: This study showed that the average differences in systolic and diastolic blood pressure comparing the lowest to highest quintile of blood lead were 4.33 mmHg (95% CI, 0.66-8.00; p for trend = 0.027) and 2.66 mmHg (95% CI, 0.26-5.06; p for trend = 0.021), respectively. After multivariate adjustment for covariates, the prevalence odds ratio (POR) of subjects in the highest quintile was associated with a 1.70-fold increase in the risks of hypertension (95% CI, 0.83-3.49; p for trend test = 0.112) over those in the lowest quintile of blood lead concentration, However, it was not statistically significant. Conclusions: This study provided evidence for an association between low- levels of blood lead and elevations in blood pressure and risk for hypertension in the general population of Korea.

키워드

참고문헌

  1. Carmignani M, Boscolo P, Poma A, Volpe AR. Kininergic system and arterial hypertension following chronic exposure to inorganic lead. Immunolopharmacology. 1999; 44: 105-110. https://doi.org/10.1016/S0162-3109(99)00115-0
  2. Glenn SB, Bandeen-Roche K, Lee BK, Weaver VM, Todd AC, Schwartz BS. Changes in systolic blood pressure associated with lead in blood and bone. Epidemiology. 2006; 17: 538-544. https://doi.org/10.1097/01.ede.0000231284.19078.4b
  3. Grizzo LT, Cordellini S. Perinatal lead exposure affects nitric oxide and cyclooxygenase pathways in aorta of weaned rats. Toxicol Sci. 2008; 103(1): 207-214. https://doi.org/10.1093/toxsci/kfn018
  4. Navas-Acien A, Schwartz BS, Rothenberg SJ, Hu H, Silbergeld EK, Guallar E. Bone lead levels and blood pressure endpoints: A meta-analysis. Epidemiology. 2008; 19(3): 496-504. https://doi.org/10.1097/EDE.0b013e31816a2400
  5. Menke A, Muntner P, Batuman V, Silbergeld EK, Guallar E. Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults. Circulation. 2006; 114: 1388-1394. https://doi.org/10.1161/CIRCULATIONAHA.106.628321
  6. Nawrot TS, Thijs L, Den Hond EM, Roels HA, Staessen JA. An epidemiological re-appraisal of the association between blood pressure and blood lead: a meta-analysis. J Human Hypertension. 2002; 16: 123-131. https://doi.org/10.1038/sj.jhh.1001300
  7. Evans M, Elinder C. Chronic renal failure from lead: myth or evidence-based fact. Kidney International. 2001; 79: 272-279.
  8. Piccinini F, Favalli L, Chiari MC. Experimental investigations on the concentration induced by lead in arterial smooth muscle. Toxicology. 1977; 8(1):43-51. https://doi.org/10.1016/0300-483X(77)90022-1
  9. Boscolo P, Carmignani M. Neurohumoral blood pressure regulation in lead exposure. Environ Health Perspect. 1988; 78: 101-9. https://doi.org/10.1289/ehp.8878101
  10. Carmignani M, Volpe AR, Boscolo P, Qiao N, Gioacchino M, Grilli A. Catcholamine and nitric oxide systems as targets of chronic lead exposure in inducing selective functional impairment. Lif Sci. 2000; 68: 401-451. https://doi.org/10.1016/S0024-3205(00)00954-1
  11. Change HR, Chen SS, Tao DA, Cheng JT, Ho CK, Yu HS. Reduced vascular beta-adrenergic receptors and catecholamine response in rats with lead induced hypertension. Arch Toxicol. 1997; 71: 778- 781. https://doi.org/10.1007/s002040050460
  12. Weiler E, Khalil-Manesh F, Gonick H. Effects of lead and natriuretic hormone on kinetic of sodium potassium ATPase: possible relevance to hypertension. Environ Health Perspect. 1988; 78: 113-115. https://doi.org/10.1289/ehp.8878113
  13. Watts SW, Chai S, Webb CR. Lead acetate-induced concentration in rabbit mesenteric artery: interaction with calcium and protein kinase C. Toxicology. 1995; 99: 55-65. https://doi.org/10.1016/0300-483X(94)03003-K
  14. Rodriguez-Iturbe B, Sindhu RK, Quiroz Y, Vaziri ND. Chronic exposure to low dose of lead results in renal infiltration of immune cells, NF-Kappa B activation, and overexpression of tubulointerstitial angiotensin II. Antioxid Redox Signal. 2005; 7: 1269- 1274. https://doi.org/10.1089/ars.2005.7.1269
  15. Sharifi AM, Darabi R, Akbarloo N, Larijani B, Khoshbaten A. Investigation of circulatory and tissue ACE activity during development of leadinduced hypertension. Toxicol Lett. 2004; 153: 233- 238. https://doi.org/10.1016/j.toxlet.2004.04.013
  16. Vaziri ND, Ding Y, Ni Z. Nitric oxide synthase expression in the course of lead-induced hypertension. Hypertension. 1999; 34: 558-562. https://doi.org/10.1161/01.HYP.34.4.558
  17. Griffith JQ Jr, Lindauer MA. The effect of chronic lead poisoning on arterial blood pressure in rats. Am Hearts J. 1944; 28: 295-297. https://doi.org/10.1016/S0002-8703(44)90089-X
  18. Schroeder HA, Vinton WH. Hypertension induced in rats by small doses of cadmium. Am J Physiol. 1962; 202: 515-518.
  19. Navas-Acien A, Eliseo Guallar, Silbergeld EK, Rothenberg SJ. Lead exposure and cardiovascular disease - A systematic review. Environ Health Perspect. 2007; 115(3): 472-482.
  20. de Kort WLAM, Verschoor MA, Wibowo AAE, Hemmen JJV. Occupational exposure to lead and blood pressure: A study in 105 workers. Am J Ind Med. 1987; 11: 145-156. https://doi.org/10.1002/ajim.4700110204
  21. Neri LC, Hewitt D, Orser B. Blood lead and blood pressure: Analysis of cross-sectional and longitudinal data from Canada. Environ Health Perspect. 1988; 78: 123-126. https://doi.org/10.1289/ehp.8878123
  22. Sharp DS, Osterloh J, Becker CE, Bernard B, Smith AH, Fisher JM, et al. Blood pressure and blood lead concentration in bus drivers. Environ Health Perspect. 1988; 78: 131-137. https://doi.org/10.1289/ehp.8878131
  23. Parkinson DK, Hodgson MJ, Bromet E, Connell MM. Occupational lead exposure and blood pressure. Br J Ind Med. 1987; 44: 744-748.
  24. Sokas RK, Simmens S, Sophar K, Welch LS, Liziewski T. Lead levels in Maryland construction workers. Am J Ind Med. 1977; 31: 188-194.
  25. Pocock Sj, Shaper AG, Ashby D, Delves T, Whitehead TP. Blood lead concentration, blood pressure and renal function. BMJ. 1984; 289: 872-874. https://doi.org/10.1136/bmj.289.6449.872
  26. Staessen J, Bulpitt CJ, Roels H. Bernard A. Fagard R, Joossens JV, et al. Urinary cadmium and lead concentrations and their relation to blood pressure in a population with low exposure. Br J Ind Med. 1984; 41: 241-248.
  27. Rahman S, Khalid N, Zaidi JH, Ahmad S, Iqbal MZ. Non-occupational lead and hypertension in Pakistani adults. J Zhejiang Univ Science B. 2006; 7(9): 732-737. https://doi.org/10.1631/jzus.2006.B0732
  28. Sirivarasai J, Kaojarern S, Wananukul W, Deechakwan W, Srisomerarn P. Non-occupational lead and cadmium exposure and blood pressure in Thai men. Asia Pac J public Health. 2004; 16(2): 133-137. https://doi.org/10.1177/101053950401600210
  29. Staessen JA, Roels H, Fagard R. Lead exposure and conventional and ambulatory blood pressure. A prospective population study. JAMA. 1996; 275(20): 1563-1570. https://doi.org/10.1001/jama.1996.03530440043035
  30. Harlan WR, Landis JR, Schmouder RL, Goldstein NG, Harlan LC. Blood lead and blood pressure. Relationship in the adolescent and US population. JAMA. 1985; 253: 530-534. https://doi.org/10.1001/jama.1985.03350280086025
  31. Pirkle JL, Schwartz J, Landis JR, Harlan WR. The relationship blood lead levels and blood pressure and its cardiovascular risk implications. Am J Epidemiol. 1985; 121: 246-258. https://doi.org/10.1093/oxfordjournals.aje.a113995
  32. Schwartz J. The relationship between blood lead and blood pressure in the NHANES II survey. Environ Health Perspect. 1988; 78: 15-22. https://doi.org/10.1289/ehp.887815
  33. Gartside PS. The relationship of blood lead levels and blood pressure in NHANES II: additional calculations. Environ Health Perspect. 1988; 78: 31-34. https://doi.org/10.1289/ehp.887831
  34. Kim NS, Lee BK. National estimates of blood lead, cadmium, and mercury levels in the Korean general adult population. Int Arch Occup Environ Health. 2011; 84: 53-63. https://doi.org/10.1007/s00420-010-0522-6
  35. Koh SB, Kim C, Nam CM, Choi HR, Cha BS, Park JK, et al. A meta-analysis of the association between blood lead and blood pressure. Korean J Prev Med. 2001; 34(3): 262-268.
  36. Harlan WR. The relationship of blood lead levels to blood pressure in the US population. Environ Health Perspect. 1988; 78: 9-13. https://doi.org/10.1289/ehp.88789
  37. Hertz-Picciotto I, Croft J. Review of the relation between blood lead and blood pressure. Epidemiol Rev. 1993; 15(2): 352-373. https://doi.org/10.1093/oxfordjournals.epirev.a036125
  38. Sharp DS, Benowitz NL, Osterloh JD, Becker CE, Smith AH, Leonard Syme S. Influence of race, tobacco use, and caffeine use on the relation between blood pressure and blood lead concentration. Am J Epidemiol. 1990; 131(5): 845-854. https://doi.org/10.1093/oxfordjournals.aje.a115575
  39. Shaper AG, Pocock SJ, Walker M, Wale CJ, Clayton B, Delves HT, et al. Effects of alcohol and smoking on blood lead in middle-aged British men. Br Med J. 1982; 284: 299-302. https://doi.org/10.1136/bmj.284.6312.299
  40. Alessio L, Apostoli P, Crippa M. Influence of individual factors and personal habits on the levels of biological indicators of exposure. Toxicology Lett. 1995; 77: 93-103. https://doi.org/10.1016/0378-4274(95)03277-0
  41. Park JU, Oh SW, Kim SH, Kim YH, Park RJ, Moon JD. A study on the association between blood lead levels and habitual tobacco and alcohol use in Koreans with no occupational lead exposure. Korean J Occup Environ Med. 2008; 20(3): 165-173.
  42. Nash D, Magder L, Lustberg M, Sherwin RW, Rubin RJ, Kaufmann RB, Silbergeld EK. Blood lead, blood pressure, and hypertension in perimenopausal and postmenopausal women. JAMA, 2003; 289(12): 1523-1532. https://doi.org/10.1001/jama.289.12.1523
  43. Yang JS, Kang SK, Park IJ, Rhee KY, Moon YH, Sohn DH. Lead concentrayions in blood among the general population of Korea. Int Arch Occup Environ Health. 1996; 68: 199-202. https://doi.org/10.1007/BF00381632
  44. Apostoli P, Maranelli G, Micciolo R. Is hypertension a confounding factor in the assessment of blood lead reference values? The Science of the Total Environment. 1992; 120: 127-134. https://doi.org/10.1016/0048-9697(92)90224-G
  45. Micciolo R, Canal L, Maranelli G, Apostoli P. Nonoccupational lead exposure and hypertension in northern Italy. Int J Epidemiol. 1994; 23(2): 312-320. https://doi.org/10.1093/ije/23.2.312
  46. Cheng Y, Schwartz J, Sparrow D, Aro A, Weiss ST, Hu H. Bone lead and blood lead levels in relation to baseline blood pressure and the prospective development of hypertension. Am J Epidemiol. 2001; 153: 164-171. https://doi.org/10.1093/aje/153.2.164
  47. Nawrot TS, Thijs L, Hond EM, Roels HA, Staessen JA. An epidemiological re-appraisal of the association between blood pressure and blood lead: a meta-analysis. J Human Hypertension. 2002; 16: 123- 131. https://doi.org/10.1038/sj.jhh.1001300
  48. Hu H, Rabinowitz M, Smith D. Bone lead as biological marker in epidemiologic studies of chronic toxicity: conceptual paradigms. Environ Health Perspect. 1998; 106(1): 1-8. https://doi.org/10.1289/ehp.981061
  49. The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-2), 2008, Korea Centers for Disease Control and Prevention.