TY - JOUR
T1 - Chronic arsenic exposure and risk of carotid artery disease
T2 - The Strong Heart Study
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
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
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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U2 - 10.1016/j.envres.2017.05.020
DO - 10.1016/j.envres.2017.05.020
M3 - Article
C2 - 28554006
AN - SCOPUS:85019768670
SN - 0013-9351
VL - 157
SP - 127
EP - 134
JO - Environmental research
JF - Environmental research
ER -