title: Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women.
abstract: OBJECTIVE
  Markers of mercury (Hg) exposure have shown both positive and negative associations with cardiovascular disease (CVD). We assessed the association between serum Hg (S-Hg) and risk of cardiovascular disease in a prospective population-based cohort, with attention to the roles of dental health and fish consumption.
  
  
  METHODS
  Total mortality, as well as morbidity and mortality from acute myocardial infarction (AMI) and stroke, was followed up for 32 years in 1,391 women (initially age 38-60), in relation to S-Hg at baseline, using Cox regression models. Potential confounders (age, socioeconomic status, serum lipids, alcohol consumption, dental health, smoking, hypertension, waist-hip ratio, and diabetes) and other covariates (e.g., fish consumption) were also considered.
  
  
  RESULTS
  Hazard ratios (HR) adjusted only for age showed strong inverse associations between baseline S-Hg and total mortality [highest quartile: hazard ratio (HR) 0.76; 95% confidence interval (CI) 0.59-0.97], incident AMI (HR 0.56; CI 0.34-0.93), and fatal AMI (HR 0.31; CI 0.15-0.66). Adjustment for potential confounding factors, especially dental health, had a strong impact on the risk estimates, and after adjustment, only the reduced risk of fatal AMI remained statistically significant.
  
  
  CONCLUSIONS
  There was a strong inverse association between Hg exposure and CVD. Likely, reasons are confounding with good dental health (also correlated with the number of amalgam fillings in these age groups) and/or fish consumption. The results suggest potential effects of dental health and/or fish consumption on CVD that deserve attention in preventive medicine.
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, SE 90185 Umeå, Sweden. Ingvar.Bergdahl@envmed.umu.se
authors.forename: Ingvar A
authors.initials: IA
authors.lastname: Bergdahl
authors.forename: Margareta
authors.initials: M
authors.lastname: Ahlqwist
authors.forename: Lars
authors.initials: L
authors.lastname: Barregard
authors.forename: Cecilia
authors.initials: C
authors.lastname: Björkelund
authors.forename: Ann
authors.initials: A
authors.lastname: Blomstrand
authors.forename: Staffan
authors.initials: S
authors.lastname: Skerfving
authors.forename: Valter
authors.initials: V
authors.lastname: Sundh
authors.forename: Maria
authors.initials: M
authors.lastname: Wennberg
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008628:Mercury / Q000097:blood*; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality*; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000401:mortality*; D013548:Sweden / Q000453:epidemiology
chemical_list: D008628:Mercury