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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/26320

Title: Association of office and ambulatory blood pressure with blood lead in workers before occupational exposure
Authors: Yang, Wen-Yi
Efremov, Ljupcho
Mujaj, Blerim
Zhang, Zhen-Yu
Wei, Fang-Fei
Huang, Qi-Fang
Thijs, Lutgarde
Vanassche, Thomas
Nawrot, Tim S.
Staessen, Jan A.
Issue Date: 2018
Abstract: In view of decreasing lead exposure and guidelines endorsing ambulatory above office blood pressure (BP) measurement, we reassessed association of BP with blood lead (BL) in 236 newly employed men (mean age, 28.6 years) without previous lead exposure not treated for hypertension. Office BP was the mean of five auscultatory readings at one visit. Twenty-four-hour BP was recorded at 15-and 30-minute intervals during wakefulness and sleep. BL was determined by inductively coupled plasma mass spectrometry. Systolic/diastolic office BP averaged 120.0/80.7 mm Hg, and the 24-hour, awake, and asleep BP 125.5/73.6, 129.3/77.9, and 117.6/65.0 mm Hg, respectively. The geometric mean of blood lead was 4.5 mu g/dL (interquartile range, 2.60-9.15 mu g/dL). In multivariable-adjusted analyses, effect sizes associated with BL doubling were 0.79/0.87 mm Hg (P = .11/.043) for office BP and 0.29/-0.25, 0.60/-0.10, and -0.40/-0.43 mm Hg for 24-hour, awake, and asleep BP (P >= .33). Neither office nor 24-hour ambulatory hypertension was related to BL (P >= .14). A clinically relevant white coat effect (WCE; office minus awake BP, >= 20/>= 10 mm Hg) was attributable to exceeding the systolic or diastolic threshold in 1 and 45 workers, respectively. With BL doubling, the systolic/diastolic WCE increased by 0.20/0.97 mm Hg (P = .57/.046). Accounting for the presence of a diastolic WCE, reduced the association size of office diastolic BP with BL to 0.39 mm Hg (95% confidence interval,-0.20 to 1.33; P = .15). In conclusion, a cross-sectional analysis of newly hired workers before lead exposure identified the WCE as confounder of the association between office BP and BL and did not reveal any association between ambulatory BP and BL. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of American Society of Hypertension.
Notes: [Yang, Wen-Yi; Efremov, Ljupcho; Mujaj, Blerim; Zhang, Zhen-Yu; Wei, Fang-Fei; Huang, Qi-Fang; Thijs, Lutgarde; Staessen, Jan A.] Univ Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium. [Vanassche, Thomas] Univ Hosp Leuven, Dept Cardiol, Leuven, Belgium. [Nawrot, Tim S.] Hasselt Univ, Ctr Environm Sci, Diepenbeek, Belgium. [Staessen, Jan A.] Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Maastricht, Netherlands.
URI: http://hdl.handle.net/1942/26320
DOI: 10.1016/j.jash.2017.10.010
ISI #: 000422812500004
ISSN: 1933-1711
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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