Blood lead and blood pressure: Evidence from the Health Survey for England1995

Objectives: To examine the relationship between blood lead and blood pressu re (BP) and to estimate the possible effects of a decrease in blood lead on BP. Methods: A 2-ml blood sample was collected from a sub-sample of those inclu ded in the Health Survey for England 1995, a cross-sectional survey of a na tionally representative sample of the adult English population. Blood lead concentration was measured by atomic absorption spectrometry and three BP r eadings were taken under standardised conditions using the Dinamap 8100 mon itor. Analyses were carried out using data on 2563 men and 2763 women aged 16 and over. Results: In stepwise multiple regression analyses adjusting for various con founders-age, body mass index, smoking status, social class, region of resi dence and alcohol intake-blood lead was found to be significantly and posit ively associated with diastolic BP, and not systolic BP in men, but not in women. These findings were unaffected by the inclusion or exclusion of thos e on antihypertensive medication, by whether mean or median BP was used in the regression, or by the adjustment for alcohol consumption. A halving of currently prevalent blood lead levels is estimated to be associated with a decrease of between 0.8 to 1.1 mm Hg diastolic BP in men. Conclusion: These findings in the context of other published data are consi stent with a small presser effect of environmental lead levels on BP. They support recommendations for further efforts to reduce lead in the environme nt.