Associations Between Metals and Nonmetals in Drinking Water, Cardiovascular Events, and Diet
Authors' conclusion
In this study, long-term exposure to higher metallic and nonmetallic elements in drinking water was associated with an increased risk of MACE. Specific dietary patterns modified the associations. Further studies are needed in this area.
Study context
- Population
- Population-based cohort from Yinzhou District, Ningbo, linked to Yinzhou Health Information Systemfinal cohort
- Participants
- 24,212 participants
- Exposure
- Long-term exposure to metals (copper, manganese, aluminum, zinc, and cadmium) and nonmetals (selenium, sulfate, and nitrate-nitrogen) in drinking water and major adverse cardiovascular events (MACE) outcomes
- Outcome
- MACE events
- Follow-up
- Between 2016 and 2022
Main finding
As reported in the abstract
- Acute myocardial infarction (AMI)
- 57
- Heart failure
- 886
- Stroke
- 733
- Angina
- 23
- Cardiovascular death
- 134
Observational data: associations, not effects.
Further findings
MACE by drinking-water exposure
- Increased risk of AMI with exposure to copper, aluminum, cadmium, and selenium
- Increased risk of stroke with exposure to zinc, copper, and selenium
- Increased risk of angina with exposure to zinc and copper
- Increased risk of cardiovascular death with exposure to zinc and aluminum
Effect modification by diet
- Consuming fish, white meat, and grain products attenuated MACE outcomes induced by metals and nonmetals in drinking water
Original publication
Associations Between Metals and Nonmetals in Drinking Water, Cardiovascular Events, and Diet. JACC Adv. Published 20 March 2025. doi:10.
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