This Article Full Text Full Text (PDF) All Versions of this Article: 105/15/1804    most recent 01.CIR.0000015862.64816.B2v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, C.-H. Articles by Chen, C.-J. Search for Related Content PubMed PubMed Citation Articles by Wang, C.-H. Articles by Chen, C.-J. Related Collections Risk Factors

(Circulation. 2002;105:1804.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Biological Gradient Between Long-Term Arsenic Exposure and Carotid Atherosclerosis

Chih-Hao Wang, MD; Jiann-Shing Jeng, MD; Ping-Keung Yip, MD; Chi-Ling Chen, PhD; Lin-I Hsu, PhD; Yu-Mei Hsueh, PhD; Hung-Yi Chiou, PhD; Meei-Mann Wu, PhD; Chien-Jen Chen, ScD

From the Graduate Institute of Epidemiology, College of Public Health, National Taiwan University (C.-H.W., C.-L.C., L.-I.H., C.-J.C.); the Department of Cardiology, Taipei Municipal Chung-Hsiao Hospital (C.-H.W.); the Department of Neurology, College of Medicine, National Taiwan University (P.-K.Y., J.-S.J.); School of Public Health, Taipei Medical University (Y.-M.H., H.-Y.C.); and Institute of Biomedical Sciences, Academia Sinica (M.-M.W.), Taiwan.

Correspondence to Dr Chien-Jen Chen, College of Public Health, National Taiwan University, 1 Jen-Ai Road Section 1, Taipei 100, Taiwan. E-mail cjchen{at}ha.mc.ntu.edu.tw

Background— Long-term exposure to ingested arsenic has been documented to induce peripheral vascular disease, ischemic heart disease, and cerebral infarction in a dose-response relationship. This study further examined the biological gradient between ingested inorganic arsenic and carotid atherosclerosis.

Methods and Results— We studied 199 male and 264 female adult residents from the southwestern area of endemic arseniasis in Taiwan. The extent of carotid atherosclerosis was assessed by duplex ultrasonography. Diabetes mellitus was determined by oral glucose tolerance test, hypertension by mercury sphygmomanometers, and serum lipid profiles by autoanalyzers. Information regarding the consumption of high-arsenic artesian well water, cigarette smoking, and alcohol consumption was obtained through standardized questionnaire interviews. Logistic regression analysis was used to estimate the odds ratio and its 95% CI of carotid atherosclerosis for various risk factors. Three indices of long-term exposure to ingested arsenic, including the duration of consuming artesian well water, the average arsenic concentration in consumed artesian well water, and cumulative arsenic exposure, were all significantly associated with prevalence of carotid atherosclerosis in a dose-response relationship. The biological gradient remained significant after adjustment for age, sex, hypertension, diabetes mellitus, cigarette smoking, alcohol consumption, waist-to-hip ratio, and serum levels of total cholesterol and LDL cholesterol. The multivariate-adjusted odds ratio was 3.1 (95% CI 1.3 to 7.4) for those who had a cumulative arsenic exposure of 20 mg/L-years compared with those without exposure to arsenic from drinking artesian well water.

Conclusions— Carotid atherosclerosis is associated with ingested inorganic arsenic, showing a significant biological gradient.

Key Words: arsenic • atherosclerosis • dose-response relationship

This article has been cited by other articles:

				J. C. States, S. Srivastava, Y. Chen, and A. Barchowsky Arsenic and Cardiovascular Disease Toxicol. Sci., February 1, 2009; 107(2): 312 - 323. [Abstract] [Full Text] [PDF]

				A. M. Hays, R. C. Lantz, L. S. Rodgers, J. J. Sollome, R. R. Vaillancourt, A. S. Andrew, J. W. Hamilton, and T. D. Camenisch Arsenic-Induced Decreases in the Vascular Matrix Toxicol Pathol, October 1, 2008; 36(6): 805 - 817. [Abstract] [Full Text] [PDF]

				A. Bhatnagar Environmental Cardiology: Studying Mechanistic Links Between Pollution and Heart Disease Circ. Res., September 29, 2006; 99(7): 692 - 705. [Abstract] [Full Text] [PDF]

				J. L. C. Bilszta, G. J. Dusting, and F. Jiang Arsenite Increases Vasoconstrictor Reactivity in Rat Blood Vessels: Role of Endothelial Nitric Oxide Function International Journal of Toxicology, July 1, 2006; 25(4): 303 - 310. [Abstract] [Full Text] [PDF]

				A. Navas-Acien, A. R. Sharrett, E. K. Silbergeld, B. S. Schwartz, K. E. Nachman, T. A. Burke, and E. Guallar Arsenic Exposure and Cardiovascular Disease: A Systematic Review of the Epidemiologic Evidence Am. J. Epidemiol., December 1, 2005; 162(11): 1037 - 1049. [Abstract] [Full Text] [PDF]

				J.-M. Chiou, S.-L. Wang, C.-J. Chen, C.-R. Deng, W. Lin, and T.-Y. Tai Arsenic ingestion and increased microvascular disease risk: observations from the south-western arseniasis-endemic area in Taiwan Int. J. Epidemiol., August 1, 2005; 34(4): 936 - 943. [Abstract] [Full Text] [PDF]

				P.-C. Lee, I-C. Ho, and T.-C. Lee Oxidative Stress Mediates Sodium Arsenite-Induced Expression of Heme Oxygenase-1, Monocyte Chemoattractant Protein-1, and Interleukin-6 in Vascular Smooth Muscle Cells Toxicol. Sci., May 1, 2005; 85(1): 541 - 550. [Abstract] [Full Text] [PDF]

				A. Bhatnagar Cardiovascular pathophysiology of environmental pollutants Am J Physiol Heart Circ Physiol, February 1, 2004; 286(2): H479 - H485. [Full Text] [PDF]

				N. V. Soucy, M. A. Ihnat, C. D. Kamat, L. Hess, M. J. Post, L. R. Klei, C. Clark, and A. Barchowsky Arsenic Stimulates Angiogenesis and Tumorigenesis In Vivo Toxicol. Sci., December 1, 2003; 76(2): 271 - 279. [Abstract] [Full Text] [PDF]

				P. Vineis Cancer as an evolutionary process at the cell level: an epidemiological perspective Carcinogenesis, January 1, 2003; 24(1): 1 - 6. [Abstract] [Full Text] [PDF]