Observational studyMedicine2016
Blood Lead and Other Metal Biomarkers as Risk Factors for Cardiovascular Disease Mortality.
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2018Pooled it
- Environmental Toxic Metals and Metalloids Exposure and Cardiovascular Health: Current Evidence from Oxidative Stress and Inflammatory Biomarkers as Indicators of Subclinical Cardiovascular Effects.Antioxidants (Basel, Switzerland) · 2026Review
- Exposure-Response Associations of Ambient Heavy Metal and Persistent Organic Pollutant with All-Cause and Cause-Specific Mortality: A Prospective Cohort Study.Environment & health (Washington, D.C.) · 2025Article
- Exposure to Lead and Coronary Artery Atherosclerosis: A Swedish Cross-Sectional Population-Based Study.Journal of the American Heart Association · 2025Article
- The independent and combined effects of blood heavy metal concentrations on all-cause mortality and cardiovascular mortality in adult patients with diabetes mellitus.Frontiers in public health · 2025Article
- Use of biomarkers of metals to improve prediction performance of cardiovascular disease mortality.Environmental health : a global access science source · 2024Article
- Do we underestimate risk of cardiovascular mortality due to lead exposure?The Science of the total environment · 2024Article
- Blood Homocysteine Levels Mediate the Association Between Blood Lead Levels and Cardiovascular Mortality.Cardiovascular toxicology · 2024Article
- Association of low-level lead exposure with all-cause and cardiovascular disease mortality in US adults with hypertension: evidence from the National Health and Nutrition Examination Survey 2003-2010.Archives of public health = Archives belges de sante publique · 2023Article
- Association of multi-metals with the risk of hypertension and the interaction with obesity: A cross-sectional study in China.Frontiers in public health · 2023Article
- Estimating the burden of diseases attributable to lead exposure in the North Africa and Middle East region, 1990-2019: a systematic analysis for the Global Burden of Disease study 2019.Environmental health : a global access science source · 2022Article
- Commentary on the Risk Assessment of Lead by the Food Safety Commission of Japan.Food safety (Tokyo, Japan) · 2022Article
- Cardiovascular Mortality and Leaded Aviation Fuel: Evidence from Piston-Engine Air Traffic in North Carolina.International journal of environmental research and public health · 2022Article
- Blood Lead Levels and Cardiovascular Disease Risk: Results from the Korean National Health and Nutrition Examination Survey.International journal of environmental research and public health · 2021Article
- Blood lead level and risk of hypertension in the United States National Health and Nutrition Examination Survey 1999-2016.Scientific reports · 2021Article
- Higher Blood Lead Level Is Associated With Increased Likelihood of Abdominal Aortic Calcification.Frontiers in cardiovascular medicine · 2021Article
- Review
- Blood Lead Concentrations and Mortality in Korean Adults: the Korea National Health and Nutrition Examination Survey with Mortality Follow-Up.International journal of environmental research and public health · 2020Article
- Developing a Health Impact Model for Adult Lead Exposure and Cardiovascular Disease Mortality.Environmental health perspectives · 2020Article
- Interpretation of Population Health Metrics: Environmental Lead Exposure as Exemplary Case.Hypertension (Dallas, Tex. : 1979) · 2020Review
Corrections and comments
- Erratum issued
- Erratum issued
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Analyses of the Third National Health and Nutrition Examination Survey (NHANES III) in 1988 to 1994 found an association of increasing blood lead levels < 10 μg/dL with a higher risk of cardiovascular disease (CVD) mortality. The potential need to correct blood lead for hematocrit/hemoglobin and adjust for biomarkers for other metals, for example, cadmium and iron, had not been addressed in the previous NHANES III-based studies on blood lead-CVD mortality association. We analyzed 1999 to 2010 NHANES data for 18,602 participants who had a blood lead measurement, were ≥ 40 years of age at the baseline examination and were followed for mortality through 2011. We calculated the relative risk for CVD mortality as a function of hemoglobin- or hematocrit-corrected log-transformed blood lead through Cox proportional hazard regression analysis with adjustment for serum iron, blood cadmium, serum C-reactive protein, serum calcium, smoking, alcohol intake, race/Hispanic origin, and sex. The adjusted relative risk for CVD mortality was 1.44 (95% confidence interval = 1.05, 1.98) per 10-fold increase in hematocrit-corrected blood lead with little evidence of nonlinearity. Similar results were obtained with hemoglobin-corrected blood lead. Not correcting blood lead for hematocrit/hemoglobin resulted in underestimation of the lead-CVD mortality association while not adjusting for iron status and blood cadmium resulted in overestimation of the lead-CVD mortality association. In a nationally representative sample of U.S. adults, log-transformed blood lead was linearly associated with increased CVD mortality. Correcting blood lead for hematocrit/hemoglobin and adjustments for some biomarkers affected the association.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.