Journal Article

Arsenic Exposure and Cardiovascular Disease: A Systematic Review of the Epidemiologic Evidence

Ana Navas-Acien, A. Richey Sharrett, Ellen K. Silbergeld, Brian S. Schwartz, Keeve E. Nachman, Thomas A. Burke and Eliseo Guallar

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 11, pages 1037-1049
Published in print December 2005 | ISSN: 0002-9262
Published online November 2005 | e-ISSN: 1476-6256 | DOI:
Arsenic Exposure and Cardiovascular Disease: A Systematic Review of the Epidemiologic Evidence

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Arsenic exposure is a likely cause of blackfoot disease and a potential risk factor for atherosclerosis. The authors performed a systematic review of the epidemiologic evidence on the association between arsenic and cardiovascular outcomes. The search period was January 1966 through April 2005. Thirteen studies conducted in general populations (eight in high-arsenic areas in Taiwan, five in other countries) and 16 studies conducted in occupational populations were identified. Exposure was assessed ecologically in most studies. In Taiwan, relative risks comparing the highest arsenic exposure category with the lowest ranged from 1.59 to 4.90 for coronary disease, from 1.19 to 2.69 for stroke, and from 1.66 to 4.28 for peripheral arterial disease. In other general populations, relative risks ranged from 0.84 to 1.54 for coronary disease, from 0.69 to 1.53 for stroke, and from 0.61 to 1.58 for peripheral arterial disease. In occupational populations, relative risks ranged from 0.40 to 2.14 for coronary disease mortality and from 0.30 to 1.33 for stroke mortality. Methodologic limitations, however, limited interpretation of the moderate-to-strong associations between high arsenic exposure and cardiovascular outcomes in Taiwan. In other populations or in occupational settings, the evidence was inconclusive. Because of the high prevalence of arsenic exposure, carefully performed studies of arsenic and cardiovascular outcomes should be a research priority.

Keywords: arsenic; arteriosclerosis; cardiovascular diseases; review [publication type]; CI, confidence interval

Journal Article.  7625 words.  Illustrated.

Subjects: Public Health and Epidemiology

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