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Blood cadmium levels and incident cardiovascular events during follow-up in a population-based cohort of swedish adults : The malmö diet and cancer study

Barregard, Lars; Sallsten, Gerd; Fagerberg, Björn; Borné, Yan LU ; Persson, Margaretha LU ; Hedblad, Bo LU and Engström, Gunnar LU (2016) In Environmental Health Perspectives 124(5). p.594-600
Abstract

Background: Cadmium exposure may increase the risk of cardiovascular disease. The only published longitudinal study on cadmium and incident cardiovascular disease was performed in American Indians with relatively high cadmium exposure. oBjectives: Our aim was to examine the association between blood cadmium at baseline and incident cardiovascular events in a population-based study of Swedish men and women with cadmium levels similar to those of most European and U.S. populations. Methods: A Swedish population-based cohort (n = 6,103, age 46-67 years) was recruited between 1991 and 1994. After we excluded those with missing data on smoking, 4,819 participants remained. Acute coronary events, other major cardiac events, stroke, and... (More)

Background: Cadmium exposure may increase the risk of cardiovascular disease. The only published longitudinal study on cadmium and incident cardiovascular disease was performed in American Indians with relatively high cadmium exposure. oBjectives: Our aim was to examine the association between blood cadmium at baseline and incident cardiovascular events in a population-based study of Swedish men and women with cadmium levels similar to those of most European and U.S. populations. Methods: A Swedish population-based cohort (n = 6,103, age 46-67 years) was recruited between 1991 and 1994. After we excluded those with missing data on smoking, 4,819 participants remained. Acute coronary events, other major cardiac events, stroke, and cardiovascular mortality were followed until 2010. Associations with blood cadmium (estimated from cadmium in erythrocytes) were analyzed using Cox proportional hazards regression including potential confounders and important cardiovascular risk factors. results: Hazard ratios for all cardiovascular end points were consistently increased for participants in the 4th blood cadmium quartile (median, 0.99 μg/L). In models that also included sex, smoking, waist circumference, education, physical activity, alcohol intake, serum triglycerides, HbA1c, and C-reactive protein, the hazard ratios comparing the highest and lowest quartiles of exposure were 1.8 (95% CI: 1.2, 2.7) for acute coronary events, and 1.9 (1.3, 2.9) for stroke. Hazard ratios in never-smokers were consistent with these estimates. conclusions: Blood cadmium in the highest quartile was associated with incident cardiovascular disease and mortality in our population-based samples of Swedish adults. The consistent results among never-smokers are important because smoking is a strong confounder. Our findings suggest that measures to reduce cadmium exposures are warranted, even in populations without unusual sources of exposure.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Environmental Health Perspectives
volume
124
issue
5
pages
7 pages
publisher
National Institute of Environmental Health Science
external identifiers
  • Scopus:84964889437
ISSN
0091-6765
DOI
10.1289/ehp.1509735
language
English
LU publication?
yes
id
42645a9c-800a-4df6-a9f2-4ba5f7846b5b
date added to LUP
2016-06-01 10:34:56
date last changed
2016-10-20 10:59:19
@misc{42645a9c-800a-4df6-a9f2-4ba5f7846b5b,
  abstract     = {<p>Background: Cadmium exposure may increase the risk of cardiovascular disease. The only published longitudinal study on cadmium and incident cardiovascular disease was performed in American Indians with relatively high cadmium exposure. oBjectives: Our aim was to examine the association between blood cadmium at baseline and incident cardiovascular events in a population-based study of Swedish men and women with cadmium levels similar to those of most European and U.S. populations. Methods: A Swedish population-based cohort (n = 6,103, age 46-67 years) was recruited between 1991 and 1994. After we excluded those with missing data on smoking, 4,819 participants remained. Acute coronary events, other major cardiac events, stroke, and cardiovascular mortality were followed until 2010. Associations with blood cadmium (estimated from cadmium in erythrocytes) were analyzed using Cox proportional hazards regression including potential confounders and important cardiovascular risk factors. results: Hazard ratios for all cardiovascular end points were consistently increased for participants in the 4th blood cadmium quartile (median, 0.99 μg/L). In models that also included sex, smoking, waist circumference, education, physical activity, alcohol intake, serum triglycerides, HbA1c, and C-reactive protein, the hazard ratios comparing the highest and lowest quartiles of exposure were 1.8 (95% CI: 1.2, 2.7) for acute coronary events, and 1.9 (1.3, 2.9) for stroke. Hazard ratios in never-smokers were consistent with these estimates. conclusions: Blood cadmium in the highest quartile was associated with incident cardiovascular disease and mortality in our population-based samples of Swedish adults. The consistent results among never-smokers are important because smoking is a strong confounder. Our findings suggest that measures to reduce cadmium exposures are warranted, even in populations without unusual sources of exposure.</p>},
  author       = {Barregard, Lars and Sallsten, Gerd and Fagerberg, Björn and Borné, Yan and Persson, Margaretha and Hedblad, Bo and Engström, Gunnar},
  issn         = {0091-6765},
  language     = {eng},
  number       = {5},
  pages        = {594--600},
  publisher    = {ARRAY(0xae71e30)},
  series       = {Environmental Health Perspectives},
  title        = {Blood cadmium levels and incident cardiovascular events during follow-up in a population-based cohort of swedish adults : The malmö diet and cancer study},
  url          = {http://dx.doi.org/10.1289/ehp.1509735},
  volume       = {124},
  year         = {2016},
}