Document Detail

Association between exposure to low to moderate arsenic levels and incident cardiovascular disease. A prospective cohort study.
MedLine Citation:
PMID:  24061511     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Long-term exposure to high levels of arsenic is associated with increased risk for cardiovascular disease, whereas risk from long-term exposure to low to moderate arsenic levels (< 100μg/L in drinking water) is unclear.
OBJECTIVE: To evaluate the association between long-term exposure to low to moderate arsenic levels and incident cardiovascular disease.
DESIGN: Prospective cohort study.
SETTING: The Strong Heart Study baseline visit between 1989 and 1991, with follow-up through 2008.
PATIENTS: 3575 American Indian men and women aged 45 to 74 years living in Arizona, Oklahoma, and North and South Dakota.
MEASUREMENTS: The sum of inorganic and methylated arsenic species in urine at baseline was used as a biomarker of long-term arsenic exposure. Outcomes were incident fatal and nonfatal cardiovascular disease.
RESULTS: A total of 1184 participants developed fatal and nonfatal cardiovascular disease. When the highest and lowest quartiles of arsenic concentrations (> 15.7 vs. < 5.8 μg/g creatinine) were compared,the hazard ratios for cardiovascular disease, coronary heart disease, and stroke mortality after adjustment for sociodemographic factors, smoking, body mass index, and lipid levels were 1.65 (95%CI, 1.20 to 2.27; P for trend < 0.001), 1.71 (CI, 1.19 to 2.44; P for trend < 0.001), and 3.03 (CI, 1.08 to 8.50; P for trend = 0.061),respectively. The corresponding hazard ratios for incident cardiovascular disease, coronary heart disease, and stroke were 1.32 (CI,1.09 to 1.59; P for trend = 0.002), 1.30 (CI, 1.04 to 1.62; P for trend = 0.006), and 1.47 (CI, 0.97 to 2.21; P for trend = 0.032).These associations varied by study region and were attenuated after further adjustment for diabetes, hypertension, and kidney disease measures.
LIMITATION: Direct measurement of individual arsenic levels in drinking water was unavailable.
CONCLUSION: Long-term exposure to low to moderate arsenic levels was associated with cardiovascular disease incidence and mortality.
Katherine A Moon; Eliseo Guallar; Jason G Umans; Richard B Devereux; Lyle G Best; Kevin A Francesconi; Walter Goessler; Jonathan Pollak; Ellen K Silbergeld; Barbara V Howard; Ana Navas-Acien
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of internal medicine     Volume:  159     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2014-01-06     Completed Date:  2014-01-27     Revised Date:  2014-09-09    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-59     Citation Subset:  AIM; IM    
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MeSH Terms
Arsenic / urine*
Biological Markers / urine
Cardiovascular Diseases / epidemiology*,  mortality
Diabetes Mellitus / epidemiology
Drinking Water
Environmental Exposure / adverse effects*
Food Contamination
Indians, North American / statistics & numerical data
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk Factors
United States / epidemiology
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Drinking Water; N712M78A8G/Arsenic
Summary for patients in:
Ann Intern Med. 2013 Nov 19;159(10):I-20   [PMID:  24400335 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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