MedicalResearch.com Interview with:
Sung Kyun Park Sc.D. M.P.H.
Associate professor of epidemiology and environmental health sciences
University of Michigan School of Public Health
Ann Arbor, Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is poorly understood that why some patients need more drugs to control high blood pressure than others. Resistant hypertension is that blood pressure is not controlled with 3 medications of different classes including diuretics or is required 4 or more medications of different classes for blood pressure controls. Genes, obesity, physical inactivity, high salt diet, pain medications may do something. Lead is a widespread environmental toxin that can influence high blood pressure. In this study, we examined whether long-term exposure to lead, measured as bone lead, is associated with the risk of resistant hypertension.
Bone lead offers a better method over blood lead measurement to discern long-term lead exposure and accumulation.
The main finding of our study is that low-level lead exposure, measured in the tibia (hard bone), is associated with higher risk of development of resistant hypertension in a cohort of patients diagnosed with hypertension.
MedicalResearch.com: What should readers take away from your report?
Response: Long-term exposure to lead may be an unrecognized risk factor for resistant hypertension. Once lead enters the body, it is very difficult to remove it. It stays several decades in your hard bones. When you get old and your bones get weak, lead can be released to the blood stream and interfere with blood pressure control. Therefore, prevention of lead exposure early in life is of paramount importance.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Lead remains an environmental toxin. As we experience recently in Flint and many other cities, there may be continuing lead exposure from old infrastructure in urban areas. An important public health implication of our study is exposure removal via infrastructure investment, including replacement of leaded pipes and removal of lead paint from old houses.
As a future step, we want to test if lifestyle modification (e.g., calcium intake or physical activity) can mitigate the observed lead effect on resistant hypertension.
We have no conflict of interest.
Low‐Level Cumulative Lead and Resistant Hypertension: A Prospective Study of Men Participating in the Veterans Affairs Normative Aging Study
Alexander R. Zheutlin, Howard Hu, Marc G. Weisskopf
David Sparrow, Pantel S. Vokonas ,Sung Kyun Park
Originally published 24 Oct 2018Journal of the American Heart Association. 2018;7:e010014
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