Lead Accumulation May Be a Risk Factor for Resistant High Blood Pressure

Lead in the tibia was associated with resistant hypertension in a study published in the Journal of the American Heart Association. 

Researchers analyzed data from the longitudinal cohort Veterans Affairs Normative Aging Study on 475 participants (all male, 96.8% white, mean age 68.2 years). They defined resistant hypertension as uncontrolled blood pressure (BP) while taking at least three antihypertensive medications or BP controlled by at least four antihypertensive medications. BP control cutoff was 140 mm Hg systolic BP (SBP) and 90 mm Hg diastolic BP (DBP). 

Lead exposure may be a risk factor for hypertension: "When you get old and your bones get weak, lead can be released to the bloodstream and interfere with blood pressure control." Read more: https://t.co/jdbN8CJHO5 @JAHA_AHA

— Cardiology Today (@CardiologyToday) October 24, 2018

Of total participants, 97 (20.4%) had resistant hypertension. Among those with resistant hypertension, median tibia lead was 20 μg/g and median patella lead was 25 μg/g, compared with 20 μg/g and 27.5 μg/g, respectively, in the non-resistant group. In adjusted models, there was a significant association between tibia lead and resistant hypertension (risk ratio [RR], 1.19; 95% CI, 1.01–1.41 [P = 0.04]), but not patella and resistant hypertension (RR, 1.10; 95% CI, 0.92–1.31 [P = 0.31]). There was a greater association between low levels of tibia lead and hypertension. 

“Whereas tibia bone lead demonstrated a significant association with resistant hypertension, this was not found when examining baseline blood lead levels as the exposure,” the researchers wrote. “Final covariate adjustment for blood lead was not found to be significantly associated with resistant hypertension (RR, 1.11; 95% CI, 0.88–1.40 [P=0.38]).” 

Early prevention is critical, according to lead study author Sung Kyun Park, ScD, MPH, an associate professor in the epidemiology and environmental health sciences department at the University of Michigan School of Public Health. 

“Once lead enters the body, it is very difficult to remove it,” he told Cardiology Today. “It stays several decades in your hard bones. When you get old and your bones get weak, lead can be released to the bloodstream and interfere with blood pressure control. Therefore, the most important clinical and public health implication of our study is to prevent lead exposure early in life.” 

Long-term outcome of transjugular intrahepatic portosystemic shunt for portal hypertension in autosomal recessive polycystic kidney disease 

Hypertension and diabetes mellitus are not associated with worse renal functional outcome after partial nephrectomy in patients with normal baseline kidney function 

Study: Obesity, Hypertension, and Diuretic Use Linked to Gout 

Association of general and central obesity with hypertension 

Sources: Journal of the American Heart Association, Cardiology Today