title: Cadmium in diet and risk of cardiovascular disease in women.
abstract: BACKGROUND
  The toxic metal cadmium is suggested to increase the risk of cardiovascular disease, but only one incidence study has explored this association. We evaluated the association between quartiles of food frequency questionnaire-based estimates of cadmium exposure from food (the predominant source of exposure to the metal) and incident cardiovascular disease and its subtypes.
  
  
  METHODS
  From the population-based Swedish Mammography cohort, 33,333 women were followed prospectively from baseline (1997) through 2010. We estimated relative risks (RRs) with 95% confidence intervals (CIs) using Cox proportional hazard models.
  
  
  RESULTS
  During 12 years of follow-up, we identified 3155 incident cases of total cardiovascular disease (1322 cases of myocardial infarction and 1833 cases of total stroke [1485 ischemic and 208 hemorrhagic stroke]). Dietary cadmium exposure was not associated with risk of total cardiovascular disease, myocardial infarction, or total stroke or its subtypes. For total cardiovascular disease, the multivariable-adjusted RR comparing the highest quartile of cadmium exposure with the lowest was 0.96 (95% CI = 0.85-1.09). The corresponding RRs were 1.07 (0.88-1.29) for myocardial infarction, 0.90 (0.76-1.05) for total stroke, 0.89 (0.74-1.06) for ischemic stroke, and 1.11 (0.68-1.80) for hemorrhagic stroke.
  
  
  CONCLUSIONS
  Our study lends no support to an overall association between low-level exposure to cadmium via food and incident cardiovascular disease.
authors.affiliation: From the aInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and bEuropean Food Safety Authority, Parma, Italy.
authors.forename: Bettina
authors.initials: B
authors.lastname: Julin
authors.forename: Charlotte
authors.initials: C
authors.lastname: Bergkvist
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.forename: Agneta
authors.initials: A
authors.lastname: Åkesson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium / Q000008:administration & dosage / Q000633:toxicity*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D004034:Diet Surveys; D005260:Female; D005500:Follow-Up Studies; D005506:Food Contamination / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013548:Sweden / Q000453:epidemiology
chemical_list: D002104:Cadmium