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Environ Res. 2017 Aug;157:127-134. doi: 10.1016/j.envres.2017.05.020. Epub 2017 May 26.

Chronic arsenic exposure and risk of carotid artery disease: The Strong Heart Study.

Author information

1
Department of Neurology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
2
Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States.
3
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
4
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
5
MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington DC, United States.
6
Missouri Breaks Industries Research, Inc, Eagle Butte, SD, United States.
7
Karl-Franzens University, Graz, Austria.
8
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
9
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
10
Division of Cardiology, Weill Cornell Medical College, New York, NY, United States.
11
Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, United States. Electronic address: an2737@cumc.columbia.edu.

Abstract

BACKGROUND:

Inorganic arsenic exposure from naturally contaminated groundwater is related to vascular disease. No prospective studies have evaluated the association between arsenic and carotid atherosclerosis at low-moderate levels. We examined the association of long-term, low-moderate inorganic arsenic exposure with carotid arterial disease.

METHODS:

American Indians, 45-74 years old, in Arizona, Oklahoma, and North and South Dakota had arsenic concentrations (sum of inorganic and methylated species, μg/g urine creatinine) measured from baseline urine samples (1989-1991). Carotid artery ultrasound was performed in 1998-1999. Vascular disease was assessed by the carotid intima media thickness (CIMT), the presence of atherosclerotic plaque in the carotid, and by the number of segments containing plaque (plaque score).

RESULTS:

2402 participants (mean age 55.3 years, 63.1% female, mean body mass index 31.0kg/m2, diabetes 45.7%, hypertension 34.2%) had a median (interquintile range) urine arsenic concentration of 9.2 (5.00, 17.06) µg/g creatinine. The mean CIMT was 0.75mm. 64.7% had carotid artery plaque (3% with >50% stenosis). In fully adjusted models comparing participants in the 80th vs. 20th percentile in arsenic concentrations, the mean difference in CIMT was 0.01 (95% confidence interval (95%CI): 0.00, 0.02) mm, the relative risk of plaque presence was 1.04 (95%CI: 0.99, 1.09), and the geometric mean ratio of plaque score was 1.05 (95%CI: 1.01, 1.09).

CONCLUSIONS:

Urine arsenic was positively associated with CIMT and increased plaque score later in life although the association was small. The relationship between urinary arsenic and the presence of plaque was not statistically significant when adjusted for other risk factors. Arsenic exposure may play a role in increasing the severity of carotid vascular disease.

KEYWORDS:

Arsenic; Atherosclerosis; Carotid stenosis; Risk factors for stroke; Vascular disease

PMID:
28554006
PMCID:
PMC5546150
DOI:
10.1016/j.envres.2017.05.020
[Indexed for MEDLINE]
Free PMC Article

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