Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Measures and Definitions
2.2.1. Urine Arsenic Measurement
2.2.2. Predicted 10-Year Risk of Hard ASCVD
2.2.3. Hypertension
2.2.4. Other Variables
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics of the Study Population
3.2. Relationship between Urine Arsenic and 10-Year Predicted ASCVD Risk
3.3. Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics | Overall | Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | p for Trend a |
---|---|---|---|---|---|---|
(≤4.92 μg/L) | (4.93–9.20 μg/L) | (9.21–21.56 μg/L) | (≥21.57 μg/L) | |||
Age (y) | 57.0 (0.5) | 56.3 (0.9) | 56.1 (1.0) | 56.6 (0.9) | 59.1 (0.9) | 0.006 |
Race (%) | ||||||
Non-Hispanic white | 75.9 (2.1) | 81.3 (3.6) | 79.8 (3.2) | 72.3 (3.5) | 70.1 (4.4) | 0.03 |
Non-Hispanic black | 11.0 (1.2) | 8.7 (2.1) | 10.7 (2.2) | 11.9 (2.4) | 12.9 (2.1) | 0.16 |
Other | 13.1 (1.5) | 10.0 (2.9) | 9.5 (2.2) | 15.8 (2.6) | 17.0 (3.3) | 0.05 |
High school education (%) | 80.6 (1.7) | 79.8 (3.9) | 82.0 (4.0) | 77.8 (3.8) | 82.7 (3.6) | 0.24 |
BMI (kg/m2) | 30.4 (0.3) | 30.4 (0.7) | 30.1 (0.4) | 30.8 (0.6) | 30.1 (0.6) | 0.86 |
Current smoking (%) | 19.0 (1.7) | 21.5 (4.1) | 24.4 (3.8) | 13.8 (3.2) | 16.3 (3.7) | 0.47 |
Serum cotinine (ng/mL) | 69.4 (7.9) | 90.8 (18.4) | 73.9 (14.4) | 56.8 (16.1) | 56.0 (16.1) | 0.09 |
Current antihypertension medication (%) | 81.2 (2.4) | 84.8 (4.5) | 70.2 (5.2) | 82.3 (3.9) | 87.6 (3.3) | 0.13 |
Systolic blood pressure (mmHg) | 130.7 (1.0) | 130.9 (1.3) | 130.8 (1.5) | 129.1 (1.8) | 132.1 (2.3) | 0.82 |
Diabetes (%) | 23.2 (2.1) | 20.3 (4.1) | 24.6 (4.3) | 23.3 (4.2) | 24.7 (5.1) | 0.90 |
Total cholesterol (mg/dL) | 197.3 (2.0) | 201.3 (4.9) | 203.8 (4.4) | 192.5 (4.0) | 191.7 (4.0) | 0.12 |
HDL cholesterol (mg/dL) | 46.8 (0.7) | 46.0 (1.4) | 47.2 (1.6) | 47.1 (1.2) | 47.0 (1.5) | 0.84 |
Predicted 10-year ASCVD risk (%) b | 10.8 (5.7–19.5) | 10.8 (6.3–19.0) | 10.0 (5.3–19.4) | 9.8 (5.3–18.0) | 11.7 (6.6–23.2) | 0.71 |
Urine creatinine (mg/dL) | 131.7 (3.4) | 82.7 (5.6) | 132.8 (7.6) | 149.5 (6.3) | 162.0 (6.3) | <0.001 |
Urine arsenic (μg/L) b | ||||||
Total arsenic | 9.2 (4.9–21.6) | 3.1 (2.1–4.2) | 7.0 (5.9–8.2) | 13.2 (10.7–16.5) | 39.0 (29.0–58.7) | |
Dimethylarsinate | 4.1 (2.6–6.9) | 1.8 (1.2–2.6) | 3.5 (3.0–4.5) | 5.4 (4.0–7.4) | 9.0 (5.7–15.1) | <0.001 |
Total arsenic minus arsenobetaine | 6.7 (3.8–11.5) | 2.3 (1.4–3.4) | 5.6 (4.6–6.7) | 9.2 (7.0–11.4) | 17.4 (11.5–27.7) | <0.001 |
Arsenobetaine | 1.9 (0.6–8.4) | 0.7 (0.3–0.8) | 0.8 (0.3–2.1) | 3.7 (1.9–6.5) | 20.9 (12.8–32.9) | <0.001 |
Characteristics | Overall | Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | p for Trend a |
---|---|---|---|---|---|---|
(≤3.30 μg/L) | (3.31–6.71 μg/L) | (6.72–14.92 μg/L) | (≥14.93 μg/L) | |||
Age (y) | 58.6 (0.5) | 58.1 (1.1) | 58.9 (0.7) | 60.0 (0.7) | 57.4 (1.1) | 0.53 |
Race (%) | ||||||
Non-Hispanic white | 75.5 (2.2) | 89.1 (2.3) | 73.8 (4.0) | 71.1 (3.1) | 68.0 (3.9) | 0.004 |
Non-Hispanic black | 13.3 (1.6) | 5.4 (1.6) | 12.8 (2.4) | 16.0 (2.3) | 19.0 (3.0) | 0.003 |
Other | 11.2 (1.4) | 5.5 (1.4) | 13.4 (3.0) | 12.9 (2.2) | 13.0 (2.4) | 0.17 |
High school education (%) | 82.8 (1.6) | 86.5 (2.7) | 81.8 (3.2) | 83.5 (2.4) | 79.4 (3.6) | 0.35 |
BMI (kg/m2) | 31.9 (0.4) | 30.6 (0.7) | 33.4 (1.0) | 32.4 (0.9) | 31.4 (0.7) | 0.42 |
Current smoking (%) | 13.1 (1.5) | 14.0 (3.6) | 14.6 (3.3) | 8.3 (2.1) | 15.4 (3.6) | 0.78 |
Serum cotinine (ng/mL) | 33.7 (3.6) | 45.6 (12.1) | 34.8 (7.4) | 21.2 (5.1) | 33.2 (7.4) | 0.91 |
Current antihypertension medication (%) | 89.4 (1.4) | 88.4 (3.0) | 89.7 (3.2) | 91.8 (2.5) | 87.7 (2.5) | 0.78 |
Systolic blood pressure (mmHg) | 130.9 (0.8) | 130.4 (1.4) | 129.6 (1.5) | 131.4 (1.8) | 132.1 (1.4) | 0.33 |
Diabetes (%) | 22.3 (1.6) | 24.3 (3.7) | 25.9 (3.7) | 20.1 (3.6) | 18.8 (3.3) | 0.10 |
Total cholesterol (mg/dL) | 206.7 (1.9) | 205.4 (4.1) | 210.5 (3.4) | 203.4 (3.5) | 207.6 (3.3) | 0.83 |
HDL cholesterol (mg/dL) | 58.1 (0.8) | 55.4 (1.2) | 57.2 (1.8) | 59.8 (1.6) | 60.1 (1.8) | 0.06 |
Predicted 10-year ASCVD risk (%) b | 6.3 (2.3–13.5) | 5.7 (2.0–13.5) | 6.6 (2.6–15.3) | 6.7 (2.9–12.4) | 5.9 (2.1–13.7) | 0.60 |
Urine creatinine (mg/dL) | 90.7 (3.6) | 41.8 (2.2) | 90.1 (5.3) | 105.6 (4.4) | 125.9 (9.7) | <0.001 |
Urine arsenic (μg/L) b | ||||||
Total arsenic | 6.7 (3.3–14.9) | 2.1 (1.4–2.5) | 5.0 (4.3–5.8) | 9.2 (7.9–11.7) | 26.3 (19.7–48.0) | |
Dimethylarsinate | 3.2 (1.9–5.4) | 1.2 (1.2–1.8) | 3.0 (2.2–3.6) | 4.4 (3.0–5.7) | 7.5 (4.4–12.2) | <0.001 |
Total arsenic minus arsenobetaine | 4.8 (2.4–8.3) | 1.4 (1.0–2.0) | 4.1 (3.2–4.8) | 6.6 (5.1–7.9) | 15.2 (9.2–21.3) | <0.001 |
Arsenobetaine | 1.2 (0.3–5.7) | 0.3 (0.3–0.8) | 0.8 (0.3–1.4) | 2.5 (0.9–4.8) | 12.4 (7.9–26.8) | <0.001 |
Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | p for Trend | |
---|---|---|---|---|---|
Total arsenic (μg/L) | ≤4.92 | 4.93–9.20 | 9.21–21.56 | ≥21.57 | |
Model 1 | 1 (reference) | 1.02 (0.80–1.30) | 0.88 (0.73–1.07) | 0.98 (0.76–1.25) | 0.92 |
Model 2 | 1 (reference) | 0.97 (0.85–1.11) | 0.97 (0.86–1.09) | 1.05 (0.92–1.19) | 0.10 |
Model 3 | 1 (reference) | 1.00 (0.88–1.14) | 1.06 (0.92–1.22) | 1.24 (1.02–1.53) | 0.007 |
Dimethylarsinate (μg/L) | ≤2.61 | 2.62–4.10 | 4.11–6.86 | ≥6.87 | |
Model 1 | 1 (reference) | 0.99 (0.82–1.19) | 0.94 (0.80–1.12) | 0.95 (0.77–1.18) | 0.64 |
Model 2 | 1 (reference) | 0.97 (0.89–1.06) | 0.98 (0.89–1.09) | 1.07 (0.98–1.17) | 0.03 |
Model 3 | 1 (reference) | 0.98 (0.90–1.08) | 1.01 (0.90–1.12) | 1.13 (1.02–1.25) | 0.003 |
Total arsenic minus arsenobetaine (μg/L) | ≤3.83 | 3.84–6.66 | 6.67–11.51 | ≥11.52 | |
Model 1 | 1 (reference) | 1.03 (0.84–1.27) | 1.03 (0.83–1.29) | 1.00 (0.78–1.27) | 0.82 |
Model 2 | 1 (reference) | 1.09 (0.98–1.20) | 1.06 (0.95–1.20) | 1.14 (1.01–1.29) | 0.04 |
Model 3 | 1 (reference) | 1.10 (0.99–1.22) | 1.10 (0.97–1.23) | 1.22 (1.05–1.40) | 0.008 |
Arsenobetaine (μg/L) | ≤0.60 | 0.61–1.92 | 1.93–8.39 | ≥8.40 | |
Model 1 | 1 (reference) | 0.94 (0.77–1.14) | 0.86 (0.73–1.03) | 0.89 (0.74–1.08) | 0.49 |
Model 2 | 1 (reference) | 0.96 (0.88–1.06) | 0.94 (0.85–1.03) | 0.98 (0.89–1.07) | 0.93 |
Model 3 | 1 (reference) | 0.96 (0.88–1.06) | 0.94 (0.86–1.03) | 0.98 (0.90–1.07) | 0.79 |
Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | p for Trend | |
---|---|---|---|---|---|
Total arsenic (μg/L) | ≤3.30 | 3.31–6.71 | 6.72–14.92 | ≥14.93 | |
Model 1 | 1 (reference) | 0.97 (0.81–1.16) | 0.85 (0.70–1.04) | 0.92 (0.73–1.16) | 0.67 |
Model 2 | 1 (reference) | 1.01 (0.90–1.14) | 1.10 (0.98–1.24) | 1.12 (0.97–1.29) | 0.11 |
Model 3 | 1 (reference) | 1.00 (0.88–1.13) | 1.07 (0.92–1.24) | 1.05 (0.85–1.29) | 0.80 |
Dimethylarsinate (μg/L) | ≤1.89 | 1.90–3.15 | 3.16–5.36 | ≥5.37 | |
Model 1 | 1 (reference) | 1.00 (0.80–1.23) | 1.07 (0.84–1.38) | 0.94 (0.71–1.23) | 0.45 |
Model 2 | 1 (reference) | 1.13 (1.00–1.27) | 1.14 (0.98–1.32) | 1.14 (0.97–1.33) | 0.39 |
Model 3 | 1 (reference) | 1.11 (0.99–1.26) | 1.11 (0.97–1.28) | 1.10 (0.92–1.30) | 0.80 |
Total arsenic minus arsenobetaine (μg/L) | ≤2.40 | 2.41–4.82 | 4.83–8.33 | ≥8.34 | |
Model 1 | 1 (reference) | 0.96 (0.80–1.16) | 0.93 (0.72–1.21) | 0.89 (0.70–1.14) | 0.34 |
Model 2 | 1 (reference) | 1.03 (0.92–1.16) | 1.15 (0.98–1.34) | 1.08 (0.94–1.25) | 0.38 |
Model 3 | 1 (reference) | 1.01 (0.89–1.14) | 1.11 (0.94–1.31) | 1.00 (0.85–1.19) | 0.64 |
Arsenobetaine (μg/L) | ≤0.30 | 0.31–1.16 | 1.17–5.70 | ≥5.71 | |
Model 1 | 1 (reference) | 1.03 (0.86–1.24) | 1.07 (0.90–1.27) | 1.00 (0.84–1.19) | 0.75 |
Model 2 | 1 (reference) | 1.02 (0.92–1.12) | 1.10 (0.99–1.21) | 1.16 (1.03–1.30) | 0.03 |
Model 3 | 1 (reference) | 1.02 (0.92–1.13) | 1.11 (1.00–1.23) | 1.20 (1.05–1.37) | 0.02 |
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Nong, Q.; Zhang, Y.; Guallar, E.; Zhong, Q. Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults. Int. J. Environ. Res. Public Health 2016, 13, 1093. https://doi.org/10.3390/ijerph13111093
Nong Q, Zhang Y, Guallar E, Zhong Q. Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults. International Journal of Environmental Research and Public Health. 2016; 13(11):1093. https://doi.org/10.3390/ijerph13111093
Chicago/Turabian StyleNong, Qingjiao, Yiyi Zhang, Eliseo Guallar, and Qiuan Zhong. 2016. "Arsenic Exposure and Predicted 10-Year Atherosclerotic Cardiovascular Risk Using the Pooled Cohort Equations in U.S. Hypertensive Adults" International Journal of Environmental Research and Public Health 13, no. 11: 1093. https://doi.org/10.3390/ijerph13111093