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Arsenic Exposure and Cardiovascular Disease:An Updated Systematic Review

  • Nutrition (BV Howard, Section Editor)
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Abstract

In epidemiologic studies, high-chronic arsenic exposure has been associated with cardiovascular disease, despite methodological limitations. At low-moderate arsenic levels, the evidence was inconclusive. Here, we update a previous systematic review (Am J Epidemiol 2005;162:1037–49) examining the association between arsenic exposure and cardiovascular disease. Eighteen studies published since 2005 were combined with 13 studies from the previous review. We calculated pooled relative risks by comparing the highest versus the lowest exposure category across studies. For high exposure (arsenic in drinking water > 50 μg/L), the pooled relative risks (95 % confidence interval) for cardiovascular disease, coronary heart disease, stroke, and peripheral arterial disease were 1.32 (95 % CI:1.05–1.67), 1.89 (95 % CI:1.33–2.69), 1.08 (95 % CI:0.98–1.19), and 2.17 (95 % CI:1.47–3.20), respectively. At low-moderate arsenic levels, the evidence was inconclusive. Our review strengthens the evidence for a causal association between high-chronic arsenic exposure and clinical cardiovascular endpoints. Additional high quality studies are needed at low-moderate arsenic levels.

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Abbreviations

CI:

Confidence Interval

CHD:

Coronary Heart Disease

CVD:

Cardiovascular Disease

PAD:

Peripheral Arterial Disease

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Acknowledgments

This research is supported by grants from the US National Heart Lung and Blood Institute (R01HL090863) and the US National Institute of Environmental Health Sciences (R01ES021367).

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Authors and Affiliations

  1. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W7604, Baltimore, MD, 21205, USA

    Katherine Moon

  2. Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W7513D, Baltimore, MD, 21205, USA

    Ana Navas-Acien

  3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Room 2-639, Baltimore, MD, 21205, USA

    Eliseo Guallar

  4. Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Eliseo Guallar & Ana Navas-Acien

  5. Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

    Eliseo Guallar

  6. Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Eliseo Guallar

  7. Department of Oncology, Johns Hopkins Medical School, Baltimore, MD, USA

    Ana Navas-Acien

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  1. Katherine Moon
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Correspondence to Ana Navas-Acien.

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Moon, K., Guallar, E. & Navas-Acien, A. Arsenic Exposure and Cardiovascular Disease:An Updated Systematic Review. Curr Atheroscler Rep 14, 542–555 (2012). https://doi.org/10.1007/s11883-012-0280-x

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