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Mercury Exposure and Risk of Cardiovascular Disease in Two U.S. Cohorts

Background Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects. Methods Among subjects from two U... Full description

Journal Title: The New England Journal of Medicine 2011, Vol.364(12), pp.1116-1125
Main Author: Mozaffarian, Dariush
Other Authors: Shi, Peilin , Morris, J. Steven , Spiegelman, Donna , Grandjean, Philippe , Siscovick, David S , Willett, Walter C , Rimm, Eric B
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ID: ISSN: 0028-4793 ; E-ISSN: 1533-4406 ; DOI: 10.1056/NEJMoa1006876
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recordid: nejm10.1056/NEJMoa1006876
title: Mercury Exposure and Risk of Cardiovascular Disease in Two U.S. Cohorts
format: Article
creator:
  • Mozaffarian, Dariush
  • Shi, Peilin
  • Morris, J. Steven
  • Spiegelman, Donna
  • Grandjean, Philippe
  • Siscovick, David S
  • Willett, Walter C
  • Rimm, Eric B
subjects:
  • Medicine
ispartof: The New England Journal of Medicine, 2011, Vol.364(12), pp.1116-1125
description: Background Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects. Methods Among subjects from two U.S. cohorts (a total of 51,529 men and 121,700 women) whose toenail clippings had been stored, we prospectively identified incident cases of cardiovascular disease (coronary heart disease and stroke) in 3427 participants and matched them to risk-set–sampled controls according to age, sex, race, and smoking status. Toenail mercury and selenium concentrations were assessed with the use of neutron-activation analysis. Other demographic characteristics, cardiovascular risk factors, fish consumption, and lifestyle habits were assessed by means of validated questionnaires. Associations between mercury exposure and incident cardiovascular disease were evaluated with the use of conditional logistic regression. Results Median toenail mercury concentrations were 0.23 μg per gram (interdecile range, 0.06 to 0.94) in the case participants and 0.25 μg per gram (interdecile range, 0.07 to 0.97) in the controls. In multivariate analyses, participants with higher mercury exposures did not have a higher risk of cardiovascular disease. For comparisons of the fifth quintile of mercury exposure with the first quintile, the relative risks were as follows: coronary heart disease, 0.85 (95% confidence interval [CI], 0.69 to 1.04; P=0.10 for trend); stroke, 0.84 (95% CI, 0.62 to 1.14; P=0.27 for trend); and total cardiovascular disease, 0.85 (95% CI, 0.72 to 1.01; P=0.06 for trend). Findings were similar in analyses of participants with low selenium concentrations or low overall fish consumption and in several additional sensitivity analyses. Conclusions We found no evidence of any clinically relevant adverse effects of mercury exposure on coronary heart disease, stroke, or total cardiovascular disease in U.S. adults at the exposure levels seen in this study. (Funded by the National Institutes of Health.) Stored toenail clippings were used to assess mercury exposure in men and women who had had incident cardiovascular events and in matched controls. Participants with higher mercury exposures did not have a higher risk of cardiovascular events, even after adjustment for fish consumption. Controversy has arisen over the risks and benefits of fish consumption in adults. Fish intake is inv
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identifier: ISSN: 0028-4793 ; E-ISSN: 1533-4406 ; DOI: 10.1056/NEJMoa1006876
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  • 0028-4793
  • 00284793
  • 1533-4406
  • 15334406
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titleMercury Exposure and Risk of Cardiovascular Disease in Two U.S. Cohorts
creatorMozaffarian, Dariush ; Shi, Peilin ; Morris, J. Steven ; Spiegelman, Donna ; Grandjean, Philippe ; Siscovick, David S ; Willett, Walter C ; Rimm, Eric B
ispartofThe New England Journal of Medicine, 2011, Vol.364(12), pp.1116-1125
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descriptionBackground Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects. Methods Among subjects from two U.S. cohorts (a total of 51,529 men and 121,700 women) whose toenail clippings had been stored, we prospectively identified incident cases of cardiovascular disease (coronary heart disease and stroke) in 3427 participants and matched them to risk-set–sampled controls according to age, sex, race, and smoking status. Toenail mercury and selenium concentrations were assessed with the use of neutron-activation analysis. Other demographic characteristics, cardiovascular risk factors, fish consumption, and lifestyle habits were assessed by means of validated questionnaires. Associations between mercury exposure and incident cardiovascular disease were evaluated with the use of conditional logistic regression. Results Median toenail mercury concentrations were 0.23 μg per gram (interdecile range, 0.06 to 0.94) in the case participants and 0.25 μg per gram (interdecile range, 0.07 to 0.97) in the controls. In multivariate analyses, participants with higher mercury exposures did not have a higher risk of cardiovascular disease. For comparisons of the fifth quintile of mercury exposure with the first quintile, the relative risks were as follows: coronary heart disease, 0.85 (95% confidence interval [CI], 0.69 to 1.04; P=0.10 for trend); stroke, 0.84 (95% CI, 0.62 to 1.14; P=0.27 for trend); and total cardiovascular disease, 0.85 (95% CI, 0.72 to 1.01; P=0.06 for trend). Findings were similar in analyses of participants with low selenium concentrations or low overall fish consumption and in several additional sensitivity analyses. Conclusions We found no evidence of any clinically relevant adverse effects of mercury exposure on coronary heart disease, stroke, or total cardiovascular disease in U.S. adults at the exposure levels seen in this study. (Funded by the National Institutes of Health.) Stored toenail clippings were used to assess mercury exposure in men and women who had had incident cardiovascular events and in matched controls. Participants with higher mercury exposures did not have a higher risk of cardiovascular events, even after adjustment for fish consumption. Controversy has arisen over the risks and benefits of fish consumption in adults. Fish intake is inversely associated with the risk of coronary heart disease, especially fatal coronary heart disease, and ischemic stroke.1 Fish are also the major source of exposure to methylmercury.2,3 Chronic, low-level methylmercury exposure appears to cause subtle but measurable neurodevelopmental delay in infants, and it is recommended that women of childbearing age, pregnant or nursing mothers, and infants and young children eat no more than two servings of fish per week and also limit their intake of selected species of fish that are especially high . . .
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titleMercury Exposure and Risk of Cardiovascular Disease in Two U.S. Cohorts
descriptionBackground Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects. Methods Among subjects from two U.S. cohorts (a total of 51,529 men and 121,700 women) whose toenail clippings had been stored, we prospectively identified incident cases of cardiovascular disease (coronary heart disease and stroke) in 3427 participants and matched them to risk-set–sampled controls according to age, sex, race, and smoking status. Toenail mercury and selenium concentrations were assessed with the use of neutron-activation analysis. Other demographic characteristics, cardiovascular risk factors, fish consumption, and lifestyle habits were assessed by means of validated questionnaires. Associations between mercury exposure and incident cardiovascular disease were evaluated with the use of conditional logistic regression. Results Median toenail mercury concentrations were 0.23 μg per gram (interdecile range, 0.06 to 0.94) in the case participants and 0.25 μg per gram (interdecile range, 0.07 to 0.97) in the controls. In multivariate analyses, participants with higher mercury exposures did not have a higher risk of cardiovascular disease. For comparisons of the fifth quintile of mercury exposure with the first quintile, the relative risks were as follows: coronary heart disease, 0.85 (95% confidence interval [CI], 0.69 to 1.04; P=0.10 for trend); stroke, 0.84 (95% CI, 0.62 to 1.14; P=0.27 for trend); and total cardiovascular disease, 0.85 (95% CI, 0.72 to 1.01; P=0.06 for trend). Findings were similar in analyses of participants with low selenium concentrations or low overall fish consumption and in several additional sensitivity analyses. Conclusions We found no evidence of any clinically relevant adverse effects of mercury exposure on coronary heart disease, stroke, or total cardiovascular disease in U.S. adults at the exposure levels seen in this study. (Funded by the National Institutes of Health.) Stored toenail clippings were used to assess mercury exposure in men and women who had had incident cardiovascular events and in matched controls. Participants with higher mercury exposures did not have a higher risk of cardiovascular events, even after adjustment for fish consumption. Controversy has arisen over the risks and benefits of fish consumption in adults. Fish intake is inversely associated with the risk of coronary heart disease, especially fatal coronary heart disease, and ischemic stroke.1 Fish are also the major source of exposure to methylmercury.2,3 Chronic, low-level methylmercury exposure appears to cause subtle but measurable neurodevelopmental delay in infants, and it is recommended that women of childbearing age, pregnant or nursing mothers, and infants and young children eat no more than two servings of fish per week and also limit their intake of selected species of fish that are especially high . . .
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abstractBackground Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects. Methods Among subjects from two U.S. cohorts (a total of 51,529 men and 121,700 women) whose toenail clippings had been stored, we prospectively identified incident cases of cardiovascular disease (coronary heart disease and stroke) in 3427 participants and matched them to risk-set–sampled controls according to age, sex, race, and smoking status. Toenail mercury and selenium concentrations were assessed with the use of neutron-activation analysis. Other demographic characteristics, cardiovascular risk factors, fish consumption, and lifestyle habits were assessed by means of validated questionnaires. Associations between mercury exposure and incident cardiovascular disease were evaluated with the use of conditional logistic regression. Results Median toenail mercury concentrations were 0.23 μg per gram (interdecile range, 0.06 to 0.94) in the case participants and 0.25 μg per gram (interdecile range, 0.07 to 0.97) in the controls. In multivariate analyses, participants with higher mercury exposures did not have a higher risk of cardiovascular disease. For comparisons of the fifth quintile of mercury exposure with the first quintile, the relative risks were as follows: coronary heart disease, 0.85 (95% confidence interval [CI], 0.69 to 1.04; P=0.10 for trend); stroke, 0.84 (95% CI, 0.62 to 1.14; P=0.27 for trend); and total cardiovascular disease, 0.85 (95% CI, 0.72 to 1.01; P=0.06 for trend). Findings were similar in analyses of participants with low selenium concentrations or low overall fish consumption and in several additional sensitivity analyses. Conclusions We found no evidence of any clinically relevant adverse effects of mercury exposure on coronary heart disease, stroke, or total cardiovascular disease in U.S. adults at the exposure levels seen in this study. (Funded by the National Institutes of Health.) Stored toenail clippings were used to assess mercury exposure in men and women who had had incident cardiovascular events and in matched controls. Participants with higher mercury exposures did not have a higher risk of cardiovascular events, even after adjustment for fish consumption. Controversy has arisen over the risks and benefits of fish consumption in adults. Fish intake is inversely associated with the risk of coronary heart disease, especially fatal coronary heart disease, and ischemic stroke.1 Fish are also the major source of exposure to methylmercury.2,3 Chronic, low-level methylmercury exposure appears to cause subtle but measurable neurodevelopmental delay in infants, and it is recommended that women of childbearing age, pregnant or nursing mothers, and infants and young children eat no more than two servings of fish per week and also limit their intake of selected species of fish that are especially high . . .
pubMassachusetts Medical Society
doi10.1056/NEJMoa1006876
pages1116-11125
date2011-03-24