Mercury, fish oils, and the risk of myocardial infarction

Eliseo Guallar, M. Inmaculada Sanz-Gallardo, Pieter Van'T Veer, Peter Bode, Antti Aro, Jorge Gómez-Aracena, Jeremy D. Kark, Rudolph A. Riemersma, José M. Martín-Moreno, Frans J. Kok

Research output: Contribution to journalArticle

Abstract

Background: It has been suggested that mercury, a highly reactive heavy metal with no known physiologic activity, increases the risk of cardiovascular disease. Because fish intake is a major source of exposure to mercury, the mercury content of fish may counteract the beneficial effects of its n-3 fatty acids. Methods: In a case-control study conducted in eight European countries and Israel, we evaluated the joint. association of mercury levels in toenail clippings and docosahexaenoic acid (C22:6n-3, or DHA) levels in adipose tissue with the risk of a first myocardial infarction among men. The patients were 684 men with a first diagnosis of myocardial infarction. The controls were 724 men selected to be representative of the same populations. Results: The average toenail mercury level in controls was 0.25 μg per gram. After adjustment for the DHA level and coronary risk factors, the mercury levels in the patients were 15 percent higher than those in controls (95 percent confidence interval, 5 to 25 percent). The risk-factor-adjusted odds ratio for myocardial infarction associated with the highest as compared with the lowest quintile of mercury was 2.16 (95 percent confidence interval, 1.09 to 4.29; P for trend = 0.006). After adjustment for the mercury level, the DHA level was inversely associated with the risk of myocardial infarction (odds ratio for the highest vs. the lowest quintile, 0.59; 95 percent confidence interval, 0.30 to 1.19; P for trend = 0.02). Conclusions: The toenail mercury level was directly associated with the risk of myocardial infarction, and the adipose-tissue DHA level was inversely associated with the risk. High mercury content may diminish the cardioprotective effect of fish intake.

Original languageEnglish (US)
Pages (from-to)1747-1754
Number of pages8
JournalNew England Journal of Medicine
Volume347
Issue number22
DOIs
StatePublished - Nov 28 2002

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Fish Oils
Mercury
Myocardial Infarction
Nails
Fishes
Confidence Intervals
Adipose Tissue
Odds Ratio
Docosahexaenoic Acids
Omega-3 Fatty Acids
Israel
Heavy Metals
Case-Control Studies
Cardiovascular Diseases
Joints

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Guallar, E., Sanz-Gallardo, M. I., Van'T Veer, P., Bode, P., Aro, A., Gómez-Aracena, J., ... Kok, F. J. (2002). Mercury, fish oils, and the risk of myocardial infarction. New England Journal of Medicine, 347(22), 1747-1754. https://doi.org/10.1056/NEJMoa020157

Mercury, fish oils, and the risk of myocardial infarction. / Guallar, Eliseo; Sanz-Gallardo, M. Inmaculada; Van'T Veer, Pieter; Bode, Peter; Aro, Antti; Gómez-Aracena, Jorge; Kark, Jeremy D.; Riemersma, Rudolph A.; Martín-Moreno, José M.; Kok, Frans J.

In: New England Journal of Medicine, Vol. 347, No. 22, 28.11.2002, p. 1747-1754.

Research output: Contribution to journalArticle

Guallar, E, Sanz-Gallardo, MI, Van'T Veer, P, Bode, P, Aro, A, Gómez-Aracena, J, Kark, JD, Riemersma, RA, Martín-Moreno, JM & Kok, FJ 2002, 'Mercury, fish oils, and the risk of myocardial infarction', New England Journal of Medicine, vol. 347, no. 22, pp. 1747-1754. https://doi.org/10.1056/NEJMoa020157
Guallar E, Sanz-Gallardo MI, Van'T Veer P, Bode P, Aro A, Gómez-Aracena J et al. Mercury, fish oils, and the risk of myocardial infarction. New England Journal of Medicine. 2002 Nov 28;347(22):1747-1754. https://doi.org/10.1056/NEJMoa020157
Guallar, Eliseo ; Sanz-Gallardo, M. Inmaculada ; Van'T Veer, Pieter ; Bode, Peter ; Aro, Antti ; Gómez-Aracena, Jorge ; Kark, Jeremy D. ; Riemersma, Rudolph A. ; Martín-Moreno, José M. ; Kok, Frans J. / Mercury, fish oils, and the risk of myocardial infarction. In: New England Journal of Medicine. 2002 ; Vol. 347, No. 22. pp. 1747-1754.
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abstract = "Background: It has been suggested that mercury, a highly reactive heavy metal with no known physiologic activity, increases the risk of cardiovascular disease. Because fish intake is a major source of exposure to mercury, the mercury content of fish may counteract the beneficial effects of its n-3 fatty acids. Methods: In a case-control study conducted in eight European countries and Israel, we evaluated the joint. association of mercury levels in toenail clippings and docosahexaenoic acid (C22:6n-3, or DHA) levels in adipose tissue with the risk of a first myocardial infarction among men. The patients were 684 men with a first diagnosis of myocardial infarction. The controls were 724 men selected to be representative of the same populations. Results: The average toenail mercury level in controls was 0.25 μg per gram. After adjustment for the DHA level and coronary risk factors, the mercury levels in the patients were 15 percent higher than those in controls (95 percent confidence interval, 5 to 25 percent). The risk-factor-adjusted odds ratio for myocardial infarction associated with the highest as compared with the lowest quintile of mercury was 2.16 (95 percent confidence interval, 1.09 to 4.29; P for trend = 0.006). After adjustment for the mercury level, the DHA level was inversely associated with the risk of myocardial infarction (odds ratio for the highest vs. the lowest quintile, 0.59; 95 percent confidence interval, 0.30 to 1.19; P for trend = 0.02). Conclusions: The toenail mercury level was directly associated with the risk of myocardial infarction, and the adipose-tissue DHA level was inversely associated with the risk. High mercury content may diminish the cardioprotective effect of fish intake.",
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AU - Sanz-Gallardo, M. Inmaculada

AU - Van'T Veer, Pieter

AU - Bode, Peter

AU - Aro, Antti

AU - Gómez-Aracena, Jorge

AU - Kark, Jeremy D.

AU - Riemersma, Rudolph A.

AU - Martín-Moreno, José M.

AU - Kok, Frans J.

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N2 - Background: It has been suggested that mercury, a highly reactive heavy metal with no known physiologic activity, increases the risk of cardiovascular disease. Because fish intake is a major source of exposure to mercury, the mercury content of fish may counteract the beneficial effects of its n-3 fatty acids. Methods: In a case-control study conducted in eight European countries and Israel, we evaluated the joint. association of mercury levels in toenail clippings and docosahexaenoic acid (C22:6n-3, or DHA) levels in adipose tissue with the risk of a first myocardial infarction among men. The patients were 684 men with a first diagnosis of myocardial infarction. The controls were 724 men selected to be representative of the same populations. Results: The average toenail mercury level in controls was 0.25 μg per gram. After adjustment for the DHA level and coronary risk factors, the mercury levels in the patients were 15 percent higher than those in controls (95 percent confidence interval, 5 to 25 percent). The risk-factor-adjusted odds ratio for myocardial infarction associated with the highest as compared with the lowest quintile of mercury was 2.16 (95 percent confidence interval, 1.09 to 4.29; P for trend = 0.006). After adjustment for the mercury level, the DHA level was inversely associated with the risk of myocardial infarction (odds ratio for the highest vs. the lowest quintile, 0.59; 95 percent confidence interval, 0.30 to 1.19; P for trend = 0.02). Conclusions: The toenail mercury level was directly associated with the risk of myocardial infarction, and the adipose-tissue DHA level was inversely associated with the risk. High mercury content may diminish the cardioprotective effect of fish intake.

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