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

Farrah J. Mateen, Maria Grau-Perez, Jonathan S. Pollak, Katherine A. Moon, Barbara V. Howard, Jason G. Umans, Lyle G. Best, Kevin A. Francesconi, Walter Goessler, Ciprian Crainiceanu, Eliseo Guallar, Richard B. Devereux, Mary J. Roman, Ana Navas-Acien

Research output: Contribution to journalArticle

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 31.0 kg/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 0.75 mm. 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.

LanguageEnglish (US)
Pages127-134
Number of pages8
JournalEnvironmental Research
Volume157
DOIs
StatePublished - 2017

Fingerprint

Carotid Artery Diseases
Arsenic
arsenic
Carotid Intima-Media Thickness
urine
Vascular Diseases
Urine
confidence interval
Confidence Intervals
Creatinine
exposure
hypertension
North American Indians
diabetes
Carotid Stenosis
Groundwater
Atherosclerotic Plaques
Medical problems
risk factor
Carotid Arteries

Keywords

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

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)

Cite this

Chronic arsenic exposure and risk of carotid artery disease : The Strong Heart Study. / Mateen, Farrah J.; Grau-Perez, Maria; Pollak, Jonathan S.; Moon, Katherine A.; Howard, Barbara V.; Umans, Jason G.; Best, Lyle G.; Francesconi, Kevin A.; Goessler, Walter; Crainiceanu, Ciprian; Guallar, Eliseo; Devereux, Richard B.; Roman, Mary J.; Navas-Acien, Ana.

In: Environmental Research, Vol. 157, 2017, p. 127-134.

Research output: Contribution to journalArticle

Mateen, FJ, Grau-Perez, M, Pollak, JS, Moon, KA, Howard, BV, Umans, JG, Best, LG, Francesconi, KA, Goessler, W, Crainiceanu, C, Guallar, E, Devereux, RB, Roman, MJ & Navas-Acien, A 2017, 'Chronic arsenic exposure and risk of carotid artery disease: The Strong Heart Study' Environmental Research, vol 157, pp. 127-134. DOI: 10.1016/j.envres.2017.05.020
Mateen FJ, Grau-Perez M, Pollak JS, Moon KA, Howard BV, Umans JG et al. Chronic arsenic exposure and risk of carotid artery disease: The Strong Heart Study. Environmental Research. 2017;157:127-134. Available from, DOI: 10.1016/j.envres.2017.05.020
Mateen, Farrah J. ; Grau-Perez, Maria ; Pollak, Jonathan S. ; Moon, Katherine A. ; Howard, Barbara V. ; Umans, Jason G. ; Best, Lyle G. ; Francesconi, Kevin A. ; Goessler, Walter ; Crainiceanu, Ciprian ; Guallar, Eliseo ; Devereux, Richard B. ; Roman, Mary J. ; Navas-Acien, Ana. / Chronic arsenic exposure and risk of carotid artery disease : The Strong Heart Study. In: Environmental Research. 2017 ; Vol. 157. pp. 127-134
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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 31.0 kg/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 0.75 mm. 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.",
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T1 - Chronic arsenic exposure and risk of carotid artery disease

T2 - Environmental Research

AU - Mateen,Farrah J.

AU - Grau-Perez,Maria

AU - Pollak,Jonathan S.

AU - Moon,Katherine A.

AU - Howard,Barbara V.

AU - Umans,Jason G.

AU - Best,Lyle G.

AU - Francesconi,Kevin A.

AU - Goessler,Walter

AU - Crainiceanu,Ciprian

AU - Guallar,Eliseo

AU - Devereux,Richard B.

AU - Roman,Mary J.

AU - Navas-Acien,Ana

PY - 2017

Y1 - 2017

N2 - 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 31.0 kg/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 0.75 mm. 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.

AB - 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 31.0 kg/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 0.75 mm. 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.

KW - Arsenic

KW - Atherosclerosis

KW - Carotid stenosis

KW - Risk factors for stroke

KW - Vascular disease

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