Arsenic in Drinking Water Tied to Heart Disease Mortality

In Bangladesh cohort, effect observed among cigarette smokers in particular

MONDAY, May 9 (HealthDay News) -- Exposure to arsenic in drinking water appears to be adversely associated with mortality from cardiovascular disease in Bangladesh, particularly among cigarette smokers, according to a study published online May 5 in BMJ.

Yu Chen, Ph.D., M.P.H., of the New York University School of Medicine in New York City, and colleagues evaluated 11,746 men and women in Araihazar, Bangladesh, who provided urine samples in 2000 and were followed up for an average of 6.6 years.

The investigators found that the mortality rate for cardiovascular disease was 214.3 per 100,000 person-years among individuals drinking water containing less than 12.0 μg/L of arsenic as compared with 271.1 per 100,000 person years in people drinking water with ≥12.0 μg/L of arsenic. After adjustment for potential confounders, the investigators found a dose-response relationship between exposure to arsenic in well water assessed at baseline and mortality from ischemic heart disease and other heart disease. They observed similar relationships when baseline total urinary arsenic was used as the exposure variable and for mortality from ischemic cardiac disease in particular. In addition, the data suggested a significant synergistic interaction between arsenic exposure and cigarette smoking in mortality from ischemic heart disease as well as other heart disease.

"In all parts of the world where groundwater is used for drinking, clinicians should therefore ask their patients where they obtain their drinking water. If it comes from a well, the next question should be whether the water has been tested for arsenic. If not, the patient should be urged to have it tested. It is too late to identify exposure after diseases caused by arsenic have been diagnosed, because many are fatal," write the authors of an accompanying editorial.

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