Peripheral Arterial Disease and Its Association With Arsenic Exposure and Metabolism in the Strong Heart Study.
Peripheral Arterial Disease and Its Association With Arsenic Exposure and Metabolism in the Strong Heart Study.
- 2016
At high levels, inorganic arsenic exposure is linked to peripheral arterial disease (PAD) and cardiovascular disease. To our knowledge, no prior study has evaluated the association between low-to-moderate arsenic exposure and incident PAD by ankle brachial index (ABI). We evaluated this relationship in the Strong Heart Study, a large population-based cohort study of American Indian communities. A total of 2,977 and 2,966 PAD-free participants who were aged 45-74 years in 1989-1991 were reexamined in 1993-1995 and 1997-1999, respectively, for incident PAD defined as either ABI <0.9 or ABI >1.4. A total of 286 and 206 incident PAD cases were identified for ABI <0.9 and ABI >1.4, respectively. The sum of inorganic and methylated urinary arsenic species (As) at baseline was used as a biomarker of long-term exposure. Comparing the highest tertile of As with the lowest, the adjusted hazard ratios were 0.57 (95% confidence interval (CI): 0.32, 1.01) for ABI <0.9 and 2.24 (95% CI: 1.01, 4.32) for ABI >1.4. Increased arsenic methylation (as percent dimethylarsinate) was associated with a 2-fold increased risk of ABI >1.4 (hazard ratio = 2.04, 95% CI: 1.02, 3.41). Long-term low-to-moderate As and increased arsenic methylation were associated with ABI >1.4 but not with ABI <0.9. Further studies are needed to clarify whether diabetes and enhanced arsenic metabolism increase susceptibility to the vasculotoxic effects of arsenic exposure. Copyright © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: [email protected].
English
0002-9262
*Arsenic/ur [Urine]
*Diabetes Mellitus, Type 2/eh [Ethnology]
*Indians, North American/sn [Statistics & Numerical Data]
*Peripheral Arterial Disease/eh [Ethnology]
Age Factors
Aged
Aged, 80 and over
Ankle Brachial Index
Antihypertensive Agents/ad [Administration & Dosage]
Arizona/ep [Epidemiology]
Biomarkers
Blood Pressure
Cholesterol, LDL/bl [Blood]
Cohort Studies
Environmental Exposure/ae [Adverse Effects]
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated/an [Analysis]
Humans
Hypertension/ep [Epidemiology]
Hypoglycemic Agents/ad [Administration & Dosage]
Incidence
Male
Menopause
Middle Aged
Midwestern United States/ep [Epidemiology]
Prospective Studies
Risk Factors
Sex Factors
Smoking/eh [Ethnology]
Socioeconomic Factors
MedStar Health Research Institute
Journal Article
At high levels, inorganic arsenic exposure is linked to peripheral arterial disease (PAD) and cardiovascular disease. To our knowledge, no prior study has evaluated the association between low-to-moderate arsenic exposure and incident PAD by ankle brachial index (ABI). We evaluated this relationship in the Strong Heart Study, a large population-based cohort study of American Indian communities. A total of 2,977 and 2,966 PAD-free participants who were aged 45-74 years in 1989-1991 were reexamined in 1993-1995 and 1997-1999, respectively, for incident PAD defined as either ABI <0.9 or ABI >1.4. A total of 286 and 206 incident PAD cases were identified for ABI <0.9 and ABI >1.4, respectively. The sum of inorganic and methylated urinary arsenic species (As) at baseline was used as a biomarker of long-term exposure. Comparing the highest tertile of As with the lowest, the adjusted hazard ratios were 0.57 (95% confidence interval (CI): 0.32, 1.01) for ABI <0.9 and 2.24 (95% CI: 1.01, 4.32) for ABI >1.4. Increased arsenic methylation (as percent dimethylarsinate) was associated with a 2-fold increased risk of ABI >1.4 (hazard ratio = 2.04, 95% CI: 1.02, 3.41). Long-term low-to-moderate As and increased arsenic methylation were associated with ABI >1.4 but not with ABI <0.9. Further studies are needed to clarify whether diabetes and enhanced arsenic metabolism increase susceptibility to the vasculotoxic effects of arsenic exposure. Copyright © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: [email protected].
English
0002-9262
*Arsenic/ur [Urine]
*Diabetes Mellitus, Type 2/eh [Ethnology]
*Indians, North American/sn [Statistics & Numerical Data]
*Peripheral Arterial Disease/eh [Ethnology]
Age Factors
Aged
Aged, 80 and over
Ankle Brachial Index
Antihypertensive Agents/ad [Administration & Dosage]
Arizona/ep [Epidemiology]
Biomarkers
Blood Pressure
Cholesterol, LDL/bl [Blood]
Cohort Studies
Environmental Exposure/ae [Adverse Effects]
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated/an [Analysis]
Humans
Hypertension/ep [Epidemiology]
Hypoglycemic Agents/ad [Administration & Dosage]
Incidence
Male
Menopause
Middle Aged
Midwestern United States/ep [Epidemiology]
Prospective Studies
Risk Factors
Sex Factors
Smoking/eh [Ethnology]
Socioeconomic Factors
MedStar Health Research Institute
Journal Article