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October 2, 1996

Hypertension and Lead Exposure-Reply

Author Affiliations

Brigham and Women's Hospital
Harvard School of Public Health Boston, Mass

JAMA. 1996;276(13):1038. doi:10.1001/jama.1996.03540130036025

In Reply.  —In response to Mr Glaser's comments, we repeated our multivariate analysis, controlling for 5 levels of education (reflecting socioeconomic status) and 3 levels of occupational status (lifetime blue collar, lifetime white collar, mixed blue collar and white collar). The effect estimate for tibia bone lead remained unchanged from that reported in Table 4 in our article, suggesting that these factors cannot explain the link between bone lead and hypertension.To address the first point of Dr Staessen and colleagues, lower blood pressure cutoff values (>140 mm Hg systolic and/or 90 mm Hg diastolic) were used to define hypertension. Tibia bone lead continued to contribute to the prediction of hypertension, and the magnitude of the effect was even higher as shown in Table 4. Our analysis of bone lead in relation to blood pressure as a continuous variable is still in progress.In the second point, Staessen et al raise the