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Lead, cadmium, smoking, and increased risk of peripheral arterial disease.
Circulation. 2004 Jun 29; 109(25):3196-201.Circ

Abstract

BACKGROUND

Lead and cadmium exposure may promote atherosclerosis, although the cardiovascular effects of chronic low-dose exposure are largely unknown. The objective of the present study was to evaluate the association between blood levels of lead and cadmium and peripheral arterial disease.

METHODS AND RESULTS

We analyzed data from 2125 participants who were > or =40 years of age in the 1999 to 2000 National Health and Nutrition Examination Survey (NHANES). Peripheral arterial disease was defined as an ankle brachial index <0.9 in at least 1 leg. Lead and cadmium levels were measured by atomic absorption spectrometry. After adjustment for demographic and cardiovascular risk factors, the ORs of peripheral arterial disease comparing quartiles 2 to 4 of lead with the lowest quartile were 1.63 (95% CI, 0.51 to 5.15), 1.92 (95% CI, 0.62 to 9.47), and 2.88 (95% CI, 0.87 to 9.47), respectively (P for trend=0.02). The corresponding ORs for cadmium were 1.07 (95% CI, 0.44 to 2.60), 1.30 (95% CI, 0.69 to 2.44), and 2.82 (95% CI, 1.36 to 5.85), respectively (P for trend=0.01). The OR of peripheral arterial disease for current smokers compared with never smokers was 4.13. Adjustment for lead reduced this OR to 3.38, and adjustment for cadmium reduced it to 1.84.

CONCLUSIONS

Blood lead and cadmium, at levels well below current safety standards, were associated with an increased prevalence of peripheral arterial disease in the general US population. Cadmium may partially mediate the effect of smoking on peripheral arterial disease.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15184277

Citation

Navas-Acien, Ana, et al. "Lead, Cadmium, Smoking, and Increased Risk of Peripheral Arterial Disease." Circulation, vol. 109, no. 25, 2004, pp. 3196-201.
Navas-Acien A, Selvin E, Sharrett AR, et al. Lead, cadmium, smoking, and increased risk of peripheral arterial disease. Circulation. 2004;109(25):3196-201.
Navas-Acien, A., Selvin, E., Sharrett, A. R., Calderon-Aranda, E., Silbergeld, E., & Guallar, E. (2004). Lead, cadmium, smoking, and increased risk of peripheral arterial disease. Circulation, 109(25), 3196-201.
Navas-Acien A, et al. Lead, Cadmium, Smoking, and Increased Risk of Peripheral Arterial Disease. Circulation. 2004 Jun 29;109(25):3196-201. PubMed PMID: 15184277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lead, cadmium, smoking, and increased risk of peripheral arterial disease. AU - Navas-Acien,Ana, AU - Selvin,Elizabeth, AU - Sharrett,A Richey, AU - Calderon-Aranda,Emma, AU - Silbergeld,Ellen, AU - Guallar,Eliseo, Y1 - 2004/06/07/ PY - 2004/6/9/pubmed PY - 2005/1/4/medline PY - 2004/6/9/entrez SP - 3196 EP - 201 JF - Circulation JO - Circulation VL - 109 IS - 25 N2 - BACKGROUND: Lead and cadmium exposure may promote atherosclerosis, although the cardiovascular effects of chronic low-dose exposure are largely unknown. The objective of the present study was to evaluate the association between blood levels of lead and cadmium and peripheral arterial disease. METHODS AND RESULTS: We analyzed data from 2125 participants who were > or =40 years of age in the 1999 to 2000 National Health and Nutrition Examination Survey (NHANES). Peripheral arterial disease was defined as an ankle brachial index <0.9 in at least 1 leg. Lead and cadmium levels were measured by atomic absorption spectrometry. After adjustment for demographic and cardiovascular risk factors, the ORs of peripheral arterial disease comparing quartiles 2 to 4 of lead with the lowest quartile were 1.63 (95% CI, 0.51 to 5.15), 1.92 (95% CI, 0.62 to 9.47), and 2.88 (95% CI, 0.87 to 9.47), respectively (P for trend=0.02). The corresponding ORs for cadmium were 1.07 (95% CI, 0.44 to 2.60), 1.30 (95% CI, 0.69 to 2.44), and 2.82 (95% CI, 1.36 to 5.85), respectively (P for trend=0.01). The OR of peripheral arterial disease for current smokers compared with never smokers was 4.13. Adjustment for lead reduced this OR to 3.38, and adjustment for cadmium reduced it to 1.84. CONCLUSIONS: Blood lead and cadmium, at levels well below current safety standards, were associated with an increased prevalence of peripheral arterial disease in the general US population. Cadmium may partially mediate the effect of smoking on peripheral arterial disease. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15184277/Lead_cadmium_smoking_and_increased_risk_of_peripheral_arterial_disease_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000130848.18636.B2?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -