title: Cadmium exposure in association with history of stroke and heart failure.
abstract: BACKGROUND
  It is unclear whether environmental cadmium exposure is associated with cardiovascular disease, although recent data suggest associations with myocardial infarction and peripheral arterial disease.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the association of measured cadmium exposure with stroke and heart failure (HF) in the general population.
  
  
  METHODS
  We analyzed data from 12,049 participants, aged 30 years and older, in the 1999-2006 National Health and Nutrition Examination Survey (NHANES) for whom information was available on body mass index, smoking status, alcohol consumption, and socio-demographic characteristics.
  
  
  RESULTS
  At their interviews, 492 persons reported a history of stroke, and 471 a history of HF. After adjusting for demographic and cardiovascular risk factors, a 50% increase in blood cadmium corresponded to a 35% increased odds of prevalent stroke [OR: 1.35; 95% confidence interval (CI): 1.12-1.65] and a 50% increase in urinary cadmium corresponded to a 9% increase in prevalent stroke [OR: 1.09; 95% CI: 1.00-1.19]. This association was higher among women [OR: 1.38; 95% CI: 1.11-1.72] than men [OR: 1.30; 95% CI: 0.93-1.79] (p-value for interaction=0.05). A 50% increase in blood cadmium corresponded to a 48% increased odds of prevalent HF [OR: 1.48; 95% CI: 1.17-1.87] and a 50% increase in urinary cadmium corresponded to a 12% increase in prevalent HF [OR: 1.12; 95% CI: 1.03-1.20], with no difference in sex-specific associations.
  
  
  CONCLUSIONS
  Environmental exposure to cadmium was associated with significantly increased stroke and heart failure prevalence. Cadmium exposure may increase these important manifestations of cardiovascular disease.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Landmark Center, P.O. Box 15697, 401 Park Drive, Boston, MA 02215, USA. jpeters@hsph.harvard.edu
authors.forename: Junenette L
authors.initials: JL
authors.lastname: Peters
authors.forename: Todd S
authors.initials: TS
authors.lastname: Perlstein
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Perry
authors.forename: Eileen
authors.initials: E
authors.lastname: McNeely
authors.forename: Jennifer
authors.initials: J
authors.lastname: Weuve
mesh_terms: D000328:Adult; D002104:Cadmium / Q000097:blood* / Q000652:urine*; D002105:Cadmium Poisoning / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology* / Q000652:urine; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D015995:Prevalence; D020521:Stroke / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology* / Q000652:urine; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D002104:Cadmium