Cadmium exposure and incident cardiovascular disease

Maria Tellez-Plaza, Eliseo Guallar, Barbara V. Howard, Jason G. Umans, Kevin A. Francesconi, Walter Goessler, Ellen Silbergeld, Richard B. Devereux, Ana Navas Acien

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Cadmium is a widespread toxic metal with potential cardiovascular effects, but no studies have evaluated cadmium and incident cardiovascular disease. We evaluated the association of urine cadmium concentration with cardiovascular disease incidence and mortality in a large population-based cohort. METHODS: We conducted a prospective cohort study of 3348 American Indian adults 45-74 years of age from Arizona, Oklahoma, and North and South Dakota, who participated in the Strong Heart Study in 1989-1991. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through 31 December 2008. RESULTS: The geometric mean cadmium level in the study population was 0.94 μg/g (95% confidence interval [CI] = 0.92-0.96). We identified 1084 cardiovascular events, including 400 deaths. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratios (HRs) (comparing the 80th to the 20th percentile of urine cadmium concentrations) was 1.43 for cardiovascular mortality (95% CI = 1.21-1.70) and 1.34 for coronary heart disease mortality (1.10-1.63). The corresponding HRs for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.24 (1.11-1.38), 1.22 (1.08-1.38), 1.75 (1.17-2.59), and 1.39 (1.01-1.94), respectively. The associations were similar in most study subgroups, including never-smokers. CONCLUSIONS: Urine cadmium, a biomarker of long-term exposure, was associated with increased cardiovascular mortality and increased incidence of cardiovascular disease. These findings support that cadmium exposure is a cardiovascular risk factor.

Original languageEnglish (US)
Pages (from-to)421-429
Number of pages9
JournalEpidemiology
Volume24
Issue number3
DOIs
StatePublished - May 2013

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Cadmium
Cardiovascular Diseases
Urine
Mortality
Coronary Disease
Confidence Intervals
North American Indians
Poisons
Incidence
Population
Mass Spectrometry
Cohort Studies
Heart Failure
Biomarkers
Metals
Stroke
Prospective Studies

ASJC Scopus subject areas

  • Epidemiology

Cite this

Tellez-Plaza, M., Guallar, E., Howard, B. V., Umans, J. G., Francesconi, K. A., Goessler, W., ... Navas Acien, A. (2013). Cadmium exposure and incident cardiovascular disease. Epidemiology, 24(3), 421-429. https://doi.org/10.1097/EDE.0b013e31828b0631

Cadmium exposure and incident cardiovascular disease. / Tellez-Plaza, Maria; Guallar, Eliseo; Howard, Barbara V.; Umans, Jason G.; Francesconi, Kevin A.; Goessler, Walter; Silbergeld, Ellen; Devereux, Richard B.; Navas Acien, Ana.

In: Epidemiology, Vol. 24, No. 3, 05.2013, p. 421-429.

Research output: Contribution to journalArticle

Tellez-Plaza, M, Guallar, E, Howard, BV, Umans, JG, Francesconi, KA, Goessler, W, Silbergeld, E, Devereux, RB & Navas Acien, A 2013, 'Cadmium exposure and incident cardiovascular disease', Epidemiology, vol. 24, no. 3, pp. 421-429. https://doi.org/10.1097/EDE.0b013e31828b0631
Tellez-Plaza M, Guallar E, Howard BV, Umans JG, Francesconi KA, Goessler W et al. Cadmium exposure and incident cardiovascular disease. Epidemiology. 2013 May;24(3):421-429. https://doi.org/10.1097/EDE.0b013e31828b0631
Tellez-Plaza, Maria ; Guallar, Eliseo ; Howard, Barbara V. ; Umans, Jason G. ; Francesconi, Kevin A. ; Goessler, Walter ; Silbergeld, Ellen ; Devereux, Richard B. ; Navas Acien, Ana. / Cadmium exposure and incident cardiovascular disease. In: Epidemiology. 2013 ; Vol. 24, No. 3. pp. 421-429.
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