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Blood Press. 2019 May 10:1-12. doi: 10.1080/08037051.2019.1610654. [Epub ahead of print]

Central hemodynamics in relation to blood lead in young men prior to chronic occupational exposure.

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a Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences , University of Leuven , Leuven , Belgium.
b Department of Endocrinology, Beijing Luhe Hospital and Key Laboratory of Diabetes Prevention and Research , Capital Medical University , Beijing , China.
c Department of Cardiology, Shanghai General Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , China.
d Unidad de Hipertensión Arterial, Hospital de Clínicas , Universidad de la República , Montevideo , Uruguay.
e Centre for Environmental Sciences , Hasselt University , Diepenbeek , Belgium.
f Department of Pharmacology , Maastricht University , Maastricht , The Netherlands.
g Cardiovascular Research Institute Maastricht (CARIM) , Maastricht University , Maastricht , The Netherlands.



Aortic pulse wave velocity (aPWV) predicts cardiovascular complications, but the association of central arterial properties with blood lead level (BL) is poorly documented. We therefore assessed their association with BL in 150 young men prior to occupational lead exposure, using baseline data of the Study for Promotion of Health in Recycling Lead (NCT02243904).


Study nurses administered validated questionnaires and performed clinical measurements. Venous blood samples were obtained after 8-12 h of fasting. The radial, carotid and femoral pulse waves were tonometrically recorded. We accounted for ethnicity, age, anthropometric characteristics, mean arterial pressure, heart rate, smoking and drinking, and total and high-density lipoprotein serum cholesterol, as appropriate.


Mean values were 4.14 μg/dL for BL, 27 years for age, 108/79/28 mm Hg for central systolic/diastolic/pulse pressure, 100/10% for the augmentation ratio/index, 1.63 for pressure amplification, 5.94 m/s for aPWV, 27/11 mm Hg for the forward/backward pulse pressure height, and 43% for the reflection index. Per 10-fold BL increase, central diastolic pressure and the augmentation ratio were respectively 5.37 mm Hg (95% confidence interval [CI], 1.00-9.75) and 1.57 (CI, 0.20-2.94) greater, whereas central pulse pressure and the forward pulse pressure height were 3.74 mm Hg (CI, 0.60-6.88) and 3.37 mm Hg (CI, 0.22-6.53) smaller (p ≤ .036 for all). The other hemodynamic measurements were unrelated to BL. The reflected pulse peak time was inversely correlated with diastolic pressure (r = -0.20; p ≤ .017).


At the exposure levels observed in our current study, aPWV, the gold standard to assess arterial stiffness, was not associated with BL. Increased peripheral arterial resistance, as reflected by higher diastolic pressure, might bring reflection points closer to the heart, thereby moving the backward wave into systole and increasing the augmentation ratio in relation to BL.


Aortic pulse wave velocity; arterial stiffness; central blood pressure; central hemodynamics; lead; occupational medicine

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