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Peripheral Arterial Disease and Its Association With Arsenic Exposure and Metabolism in the Strong Heart Study.

by Howard, Barbara V; Umans, Jason G.
Citation: American Journal of Epidemiology. 184(11):806-817, 2016 Dec 01.Journal: American journal of epidemiology.Published: 2016ISSN: 0002-9262.Full author list: Newman JD; Navas-Acien A; Kuo CC; Guallar E; Howard BV; Fabsitz RR; Devereux RB; Umans JG; Francesconi KA; Goessler W; Best LT; Tellez-Plaza M.UI/PMID: 27810857.Subject(s): Age Factors | Aged | Aged, 80 and over | Ankle Brachial Index | Antihypertensive Agents/ad [Administration & Dosage] | Arizona/ep [Epidemiology] | *Arsenic/ur [Urine] | Biomarkers | Blood Pressure | Cholesterol, LDL/bl [Blood] | Cohort Studies | *Diabetes Mellitus, Type 2/eh [Ethnology] | Environmental Exposure/ae [Adverse Effects] | Female | Glomerular Filtration Rate | Hemoglobin A, Glycosylated/an [Analysis] | Humans | Hypertension/ep [Epidemiology] | Hypoglycemic Agents/ad [Administration & Dosage] | Incidence | *Indians, North American/sn [Statistics & Numerical Data] | Male | Menopause | Middle Aged | Midwestern United States/ep [Epidemiology] | *Peripheral Arterial Disease/eh [Ethnology] | Prospective Studies | Risk Factors | Sex Factors | Smoking/eh [Ethnology] | Socioeconomic FactorsInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1093/aje/kww002 (Click here) Abbreviated citation: Am J Epidemiol. 184(11):806-817, 2016 Dec 01.Abstract: At high levels, inorganic arsenic exposure is linked to peripheral arterial disease (PAD) and cardiovascular disease. To our knowledge, no prior study has evaluated the association between low-to-moderate arsenic exposure and incident PAD by ankle brachial index (ABI). We evaluated this relationship in the Strong Heart Study, a large population-based cohort study of American Indian communities. A total of 2,977 and 2,966 PAD-free participants who were aged 45-74 years in 1989-1991 were reexamined in 1993-1995 and 1997-1999, respectively, for incident PAD defined as either ABI <0.9 or ABI >1.4. A total of 286 and 206 incident PAD cases were identified for ABI <0.9 and ABI >1.4, respectively. The sum of inorganic and methylated urinary arsenic species (As) at baseline was used as a biomarker of long-term exposure. Comparing the highest tertile of As with the lowest, the adjusted hazard ratios were 0.57 (95% confidence interval (CI): 0.32, 1.01) for ABI <0.9 and 2.24 (95% CI: 1.01, 4.32) for ABI >1.4. Increased arsenic methylation (as percent dimethylarsinate) was associated with a 2-fold increased risk of ABI >1.4 (hazard ratio = 2.04, 95% CI: 1.02, 3.41). Long-term low-to-moderate As and increased arsenic methylation were associated with ABI >1.4 but not with ABI <0.9. Further studies are needed to clarify whether diabetes and enhanced arsenic metabolism increase susceptibility to the vasculotoxic effects of arsenic exposure.Abstract: Copyright © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: [email protected]

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