TY  - BOOK
AU  - Howard, Barbara V
AU  - Umans, Jason G
TI  - Cadmium exposure and incident cardiovascular disease
SN  - 1044-3983
KW  - *Cadmium/ae [Adverse Effects]
KW  - *Cardiovascular Diseases/ci [Chemically Induced]
KW  - *Environmental Exposure/ae [Adverse Effects]
KW  - *Environmental Pollutants/ae [Adverse Effects]
KW  - Aged
KW  - Arizona/ep [Epidemiology]
KW  - Cadmium/ur [Urine]
KW  - Cardiovascular Diseases/eh [Ethnology]
KW  - Cardiovascular Diseases/mo [Mortality]
KW  - Environmental Exposure/an [Analysis]
KW  - Environmental Pollutants/ur [Urine]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Incidence
KW  - Indians, North American
KW  - Male
KW  - Mass Spectrometry
KW  - Middle Aged
KW  - Models, Statistical
KW  - North Dakota/ep [Epidemiology]
KW  - Oklahoma/ep [Epidemiology]
KW  - Proportional Hazards Models
KW  - Prospective Studies
KW  - South Dakota/ep [Epidemiology]
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 2000 - present
N2  - BACKGROUND: Cadmium is a widespread toxic metal with potential cardiovascular effects, but no studies have evaluated cadmium and incident cardiovascular disease. We evaluated the association of urine cadmium concentration with cardiovascular disease incidence and mortality in a large population-based cohort; CONCLUSIONS: Urine cadmium, a biomarker of long-term exposure, was associated with increased cardiovascular mortality and increased incidence of cardiovascular disease. These findings support that cadmium exposure is a cardiovascular risk factor; METHODS: We conducted a prospective cohort study of 3348 American Indian adults 45-74 years of age from Arizona, Oklahoma, and North and South Dakota, who participated in the Strong Heart Study in 1989-1991. Urine cadmium was measured using inductively coupled plasma mass spectrometry. Follow-up extended through 31 December 2008; RESULTS: The geometric mean cadmium level in the study population was 0.94 mug/g (95% confidence interval [CI] = 0.92-0.96). We identified 1084 cardiovascular events, including 400 deaths. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratios (HRs) (comparing the 80th to the 20th percentile of urine cadmium concentrations) was 1.43 for cardiovascular mortality (95% CI = 1.21-1.70) and 1.34 for coronary heart disease mortality (1.10-1.63). The corresponding HRs for incident cardiovascular disease, coronary heart disease, stroke, and heart failure were 1.24 (1.11-1.38), 1.22 (1.08-1.38), 1.75 (1.17-2.59), and 1.39 (1.01-1.94), respectively. The associations were similar in most study subgroups, including never-smokers
UR  - http://dx.doi.org/10.1097/EDE.0b013e31828b0631
ER  -