The Effect of Chelation on Blood Pressure in Lead-Exposed Children: A Randomized Study Aimin Chen,1 George G. Rhoads,2 Bo Cai,3 Mikhail
Salganik,4 and Walter J. Rogan1 1Epidemiology Branch, National Institute of Environmental Health
Sciences, National Institutes of Health, U.S. Department of Health and Human
Services, Research Triangle Park, North Carolina, USA; 2Environmental
and Occupational Health Sciences Institute, University of Medicine and Dentistry
of New Jersey, Piscataway, New Jersey, USA; 3Biostatistics Branch,
National Institute of Environmental Health Sciences, National Institutes of
Health, U.S. Department of Health and Human Services, Research Triangle Park,
North Carolina, USA; 4Harvard School of Public Health, Harvard University,
Boston, Massachusetts, USA Abstract Studies in children suggest a weak association between blood lead concentration and blood pressure. To understand this better, we tested the strength of the association in children with elevated blood lead concentrations and whether succimer chelation changed blood pressure as it did blood lead. In a randomized clinical trial of 780 children with blood lead concentrations of 20-44 µg/dL at 12-33 months of age, we compared the systolic and diastolic blood pressure in the succimer-treated group and placebo group for up to 5 years of follow-up. We also analyzed the relation of blood lead to blood pressure. Children in the succimer group had lower blood lead concentrations for 9-10 months during and after treatment, but their blood pressure did not differ from those in the placebo group during this period. During 1-5 years of follow-up, children in the succimer group had systolic blood pressure 1.09 (95% confidence interval, 0.27-1.90) mmHg higher than did untreated children in a model with repeated measurements, but the difference in diastolic blood pressure was not statistically significant. No association between blood lead and blood pressure was found. Overall, there is no association between blood lead and blood pressure in these children with moderately high lead exposure, nor does chelation with succimer change blood pressure. Key words: blood pressure, chelation, child, lead, succimer. Environ Health Perspect 114:579-583 (2006) . doi:10.1289/ehp.8634 available via http://dx.doi.org/ [Online 24 January 2006]
Address correspondence to W.J. Rogan, Epidemiology Branch, NIEHS, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709 USA. Telephone: (919) 541-4578. Fax: (919) 541-2511. E-mail: rogan@niehs.nih.gov The Treatment of Lead-Exposed Children trial was supported by NIEHS in cooperation with the National Institutes of Health Office of Minority Health, and by the Centers for Disease Control and Prevention. Succimer and placebo capsules were gifts from McNeil Laboratories, Fort Washington, PA. The authors declare they have no competing financial interests. Received 6 September 2005 ; accepted 23 January 2006. The full version of this article is available for free in HTML or PDF formats. |