Chronic Low-Level Lead Exposure
- 1 June 1987
- journal article
- review article
- Published by Springer Nature in Medical Toxicology
- Vol. 2 (3) , 210-232
- https://doi.org/10.1007/bf03259865
Abstract
Lead is a common element in the earth’s crust, serving useful purposes in industry, but serving no purpose in the human body. Increase in blood pressure is an important public health problem with numerous factors contributing to many facets of the disease. The relationship of lead exposure and increased blood pressure has long been considered, but only recently critically investigated. Reports of subtle changes in calcium metabolism and renal function, as well as in vitro studies examining end-arteriolar smooth muscle contractility, link lead exposure and increased blood pressure. This paper critically examines the evidence associating chronic low-level lead exposure and increased blood pressure. The review focuses on epidemiological, clinical, and toxicological data. The epidemiological evidence is consistent with low-level exposure to lead causing an elevation in blood pressure. The strength of that association, and the doseresponse characteristics, are less certain. Individual resistance and susceptibility could affect the degree of blood pressure elevation. The results of animal and in vitro studies are consistent with the epidemiological evidence, and suggest biologically plausible mechanisms for the association. The most probable mechanisms are intracellular pertubations in calcium metabolism mediated by direct lead effects at the end-arteriole, and indirect effects via renal dysfunction. Better indices of lead exposure and lead activity are needed to quantify these effects in humans. New and safer methods of chelating lead suggest interesting approaches for studying the relationship between lead and hypertension. This link could have significant implications in determining what constitutes a ‘safe’ level of environmental lead exposure, and whether a proportion of essential hypertension could be ‘cured’ by chelation therapy.Keywords
This publication has 150 references indexed in Scilit:
- Calcium and Ischemic InjuryNew England Journal of Medicine, 1986
- Correlation of Platelet Calcium with Blood PressureNew England Journal of Medicine, 1984
- Lead activates calmodulin sensitive processesLife Sciences, 1983
- Contribution of Lead to Hypertension with Renal ImpairmentNew England Journal of Medicine, 1983
- Chronological Trend in Blood Lead Levels between 1976 and 1980New England Journal of Medicine, 1983
- Low Serum Concentrations of Ionized Calcium in Patients with HypertensionNew England Journal of Medicine, 1982
- Plasma renin activity and urinary kallikrein excretion in lead-exposed workers as related to hypertension and nephropathyLife Sciences, 1981
- Effects of environmental lead levels on the urinary kallikrein excretion of exposed workersLife Sciences, 1977
- Urinary kallikrein excretion in lead intoxicationLife Sciences, 1975
- The effect of chronic lead poisoning on arterial blood pressure in dogsAmerican Heart Journal, 1942