Arsenic and cardiovascular disease: 100 years advancing epidemiologic research

摘要

Evidence indicates that arsenic may be a risk factor for cardiovascular disease. The cardiovascular effects of arsenic were first mentioned in reports of cases occurring in Argentina and Taiwan around 1917-1920. Ecological studies in Northern Chile advanced our understanding of the impact of adding and removing arsenic in drinking water for the rise and fall of an epidemic of cardiovascular disease in the population, and the importance of early life exposure. Prospective cohort studies from Taiwan and Bangladesh showed a dose-response relationship of chronic moderate-high arsenic exposure in drinking water with the development of coronary heart disease and maybe stroke. At low-moderate arsenic exposure levels, prospective cohort studies in the US have shown an association with coronary heart disease at levels above 10 μg/L. Evidence is needed to assess cardiovascular risk at levels below 10 μg/L, the shape of the dose-response, and the role of arsenic sources of exposure beyond groundwater.