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Environ Health Perspect. 2013 Jul;121(7):832-8. doi: 10.1289/ehp.1205797. Epub 2013 May 10.

A prospective study of arsenic exposure, arsenic methylation capacity, and risk of cardiovascular disease in Bangladesh.

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1
Department of Population Health, New York University School of Medicine, New York, New York 10016, USA. yu.chen@nyumc.org

Abstract

BACKGROUND:

Few prospective studies have evaluated the influence of arsenic methylation capacity on cardiovascular disease (CVD) risk.

OBJECTIVE:

We evaluated the association of arsenic exposure from drinking water and arsenic methylation capacity with CVD risk.

METHOD:

We conducted a case-cohort study of 369 incident fatal and nonfatal cases of CVD, including 211 cases of heart disease and 148 cases of stroke, and a subcohort of 1,109 subjects randomly selected from the 11,224 participants in the Health Effects of Arsenic Longitudinal Study (HEALS).

RESULTS:

The adjusted hazard ratios (aHRs) for all CVD, heart disease, and stroke in association with a 1-SD increase in baseline well-water arsenic (112 µg/L) were 1.15 (95% CI: 1.01, 1.30), 1.20 (95% CI: 1.04, 1.38), and 1.08 (95% CI: 0.90, 1.30), respectively. aHRs for the second and third tertiles of percentage urinary monomethylarsonic acid (MMA%) relative to the lowest tertile, respectively, were 1.27 (95% CI: 0.85, 1.90) and 1.55 (95% CI: 1.08, 2.23) for all CVD, and 1.65 (95% CI: 1.05, 2.60) and 1.61 (95% CI: 1.04, 2.49) for heart disease specifically. The highest versus lowest ratio of urinary dimethylarsinic acid (DMA) to MMA was associated with a significantly decreased risk of CVD (aHR = 0.54; 95% CI: 0.34, 0.85) and heart disease (aHR = 0.54; 95% CI: 0.33, 0.88). There was no significant association between arsenic metabolite indices and stroke risk. The effects of incomplete arsenic methylation capacity--indicated by higher urinary MMA% or lower urinary DMA%--with higher levels of well-water arsenic on heart disease risk were additive. There was some evidence of a synergy of incomplete methylation capacity with older age and cigarette smoking.

CONCLUSIONS:

Arsenic exposure from drinking water and the incomplete methylation capacity of arsenic were adversely associated with heart disease risk.

PMID:
23665672
PMCID:
PMC3701993
DOI:
10.1289/ehp.1205797
[Indexed for MEDLINE]
Free PMC Article
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