Researchers from the Johns Hopkins Bloomberg School of Public Health
have found a link between levels of lead and cadmium -- both toxic and
carcinogenic metals -- in the blood and peripheral arterial disease
(PAD). The levels of lead and cadmium studied were well below the
current U.S. safety standards. 

Eliseo Guallar <http://faculty.jhsph.edu/?F=Eliseo&L=Guallar> , MD,
DrPH, the study's senior author, explained that the general public can
be exposed to lead and cadmium through smoking  (as well as through our
food, water and industrial activities).

Although the cardiovascular effects of chronic exposure to low doses of
lead and cadmium are not well understood, past studies have shown that
lead exposure is linked to elevated blood pressure and to increased
cardiovascular mortality. In this study, Johns Hopkins researchers
focused on PAD, a condition characterized by reduced blood flow to the
legs due to atherosclerosis. A typical symptom is pain in the legs
during activity.
The researchers studied 2,125 adults and found that those with the
highest blood concentrations of lead or cadmium were 2.8 times more
likely to develop PAD.

In addition, the investigators observed that the odds of developing PAD
for current smokers compared to people who never smoked changed from
4.13 to 3.38 after adjusting for blood lead, and to 1.84 after adjusting
for blood cadmium. This led Dr. Guallar to speculate that the cadmium
contained in cigarette smoke may damage the lining of blood vessels and
becomes a major contributor to smoking-related PAD.

Dr. Guallar, an assistant professor in the School's Department of
Epidemiology </Dept/EPI/index.html> , said, "We don't need any more
reasons to argue that smoking is bad, but it is important to know what
are the mechanisms of the problems associated with smoking. We need to
know if there is something about cigarette smoke that makes it more
specific to PAD than other vascular diseases."

"The levels of the toxins found in the study participants were below the
current standards, which have been steadily lowered over the past few
years. Scientists need to think more carefully about the association
between metals and PAD. More experiments with cadmium and lead at lower
doses need to be done to determine what exposures might be problematic
in terms of risk for cardiovascular disease," said Dr. Guallar.

"Lead, Cadmium, Smoking and Increased Risk of Peripheral Arterial
Disease" was published online on June 8, 2004, and will appear in the
June 29, 2004, issue of Circulation <http://circ.ahajournals.org/> , the
journal of the American Heart Association <http://www.americanheart.org>
.
Jo Miller
Cedar Isles Dean Neighborhood



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