Blood lead level and blood pressure during pregnancy in South Central Los Angeles.

In many studies in which the relationship between blood pressure and blood lead level has been examined, investigators have found significant--but small--associations. There was only one previous report of a significant association of blood lead with blood pressure in pregnant women. We measured blood lead level and sitting blood pressure of 1,627 women in their third trimester of pregnancy. We eliminated subjects with known causes of hypertension. Most women (98.4%) were normotensive. We controlled for body mass index, age, and stress--among other factors--and constructed multiple-regression models of lead association with diastolic and systolic blood pressures. Immigrants (73% of total) had significantly higher blood lead levels and different blood pressures than nonimmigrants, suggesting that analysis be stratified by "immigrant, nonimmigrant" status. Positive relationships between blood lead level and blood pressure were found only for immigrants (p < or = .001). From the 5th to 95th blood-lead percentiles (0.9-6.2 microg/dl) in immigrants, systolic blood pressure increased 2.8 mm Hg, and diastolic blood pressure increased 2.4 mm Hg. Higher prior lead exposure of immigrants (97.7% from Latin countries) than nonimmigrants might explain the differential effect of these low levels of blood lead on blood pressure in nonimmigrants. Perhaps some immigrants are at higher risk than nonimmigrants for lead-associated elevated blood pressure during pregnancy, despite blood lead levels within the currently considered acceptable range.