ABSTRACT
Studies on the possible association between blood pressure and blood lead have reached divergent conclusions. In a previous meta-analysis, a doubling of the blood lead concentration was associated with a 1.0/0.6 mm Hg increase in systolic and diastolic blood pressure (BP). This meta-analysis updates the analysis originally performed in 1994. Articles on the association between BP and blood lead were identified from computer searches from January 1980 to February 2001 using the Medical Literature Analysis and Retrieval System. Of the studies reviewed, 31 provided sufficient details to be considered. The meta-analysis included 58518 subjects recruited from the general population in 19 surveys and from occupationally exposed groups in 12 studies. In all but four studies, the results were adjusted for age, and most studies took into account additional confounding factors such as body mass index and the use of alcohol and medication. Weighted joint P-values were calculated using Stouffer's procedure. The association between BP and blood lead was similar in both men and women. In the combined studies, a two-fold increase in blood lead concentration was associated with a 1.0 mm Hg rise in the systolic pressure (95% CI +0.5 to +1.4 mm Hg; P < 0.001) and with a 0.6 mm Hg increase in the diastolic pressure (95% CI +0.4 to +0.8 mm Hg; P < 0.001). On balance, this meta-analysis suggests that there can only be a weak association between BP and blood lead.
Subject(s)
Hypertension/epidemiology , Lead Poisoning/epidemiology , Lead/blood , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Belgium/epidemiology , Blood Pressure/physiology , Blood Pressure Determination , Chi-Square Distribution , Child , Child, Preschool , Comorbidity , Female , Humans , Hypertension/diagnosis , Male , Middle Aged , Probability , Risk Assessment , Risk Factors , Sensitivity and Specificity , Sex DistributionABSTRACT
OBJECTIVE: In Belgium, important regional differences in mortality exist which have been linked to differences in dietary consumption patterns. METHODS: To study regional food consumption in Belgium, sales data of 103 spreading and cooking fat products in 110 branch stores of a major supermarket chain (Colruyt) for 12 months (1991-92) were analyzed. RESULTS: Sale of more ordinary and polyunsaturated spreading margarine and of more polyunsaturated low-fat spread in the north in combination with a greater sale of butter and dairy low-fat spread in the south resulted in a P/S-ratio of 0.99 in the north vs. 0.40 in the south (p < 0.001) and a U/S-ratio of 1.93 vs. 1.10 (p < 0.001) for spreading fats. The P/S- and U/S-ratios of cooking fats were lower in the north (ns). Mortality data correlated positively with the sale of butter and dairy low-fat spread and negatively with sales data of spreading margarine, polyunsaturated spreading margarine, and polyunsaturated low-fat spread (all p < 0.001). CONCLUSION: Sales data from supermarket chains provide useful information on regional fat consumption and offer interesting perspectives of trends over time.
