Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions
Abstract
:1. Introduction
2. Fish and Cardiovascular Risk
3. Mercury and Cardiovascular Risk
4. Selenium and Cardiovascular Risk
5. Interaction between Mercury, Selenium and Cardiovascular Risk
6. Polychlorinated Biphenyls (PCBs) and Dioxins
7. Conclusions
Acknowledgments
- Disclosures: Research grants (significant) from NHLBI and NIEHS (K08 HL 075628-01, R01 HL 085710-01, R01 ES 014433-01A2); the Searle Scholar Award from the Searle Funds at The Chicago Community Trust; the Genes and Environment Initiative at the Harvard School of Public Health; the Gates Foundation/World Health Organization Global Burden of Diseases, Injuries, and Risk Factors Study; and GSK, Sigma Tau, and Pronova for an investigator-initiated trial of fish oil to prevent post-surgical arrhythmia. Honoraria (modest) for speaking at scientific conferences and reviewing on topics related to diet and cardiovascular disease, including from the U.S. Food and Drug Administration, United Nations, World Health Organization, UpToDate, International Life Sciences Institute, Aramark, and several universities and scientific organizations. No ownership, patents, stocks, advisory board membership, nor speaking board membership.
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Systemic Effects |
Promotion of free radicals and reactive oxygen species |
Inhibition of antioxidant systems (glutathione peroxidase, catalase, superoxide dismutase) |
Increased lipid (e.g., LDL cholesterol) peroxidation |
Promotion of blood coagulation (clotting) |
Inhibition of endothelial cell migration |
Direct Cardiovascular Effects |
Reduction in myocardial contractile force |
Increased calcium release from myocardial sarcoplasmic reticulum |
Reduction in left ventricular myosin ATPase activity |
Decreased heart rate variability and increased blood pressure |
Author, Year | Design | Country | Exposure | Outcome | No. of Cases | Relative Risk (5% CI) with High Mercury * |
---|---|---|---|---|---|---|
Ahlqwist, 1999 | Prospective cohort | Sweden | Serum mercury | Total myocardial infarction, Stroke | 87, 77 | RR = 0.71 (0.40, 1.26)† for MI; RR = NS (data not reported) for stroke |
Hallgren, 2001 | Prospective (nested) case-control | Sweden | Erythrocyte mercury | Total myocardial infarction | 78 | RR = 0.51 (0.21, 1.24) |
Guallar, 2002 | Retrospective case-control | 8 European countries and Israel | Toenail mercury | Nonfatal myocardial infarction | 684 | RR = 2.16 (1.09, 4.29) |
Yoshizawa, 2002 | Prospective (nested) case-control | USA | Toenail mercury | Total myocardial infarction + coronary revascularization | 470 | RR = 1.03 (0.65, 1.65) |
Virtanen, 2005 | Prospective cohort | Finland | Hair mercury | Total acute coronary events | 282 | RR = 1.66 (1.20, 2.29) |
Wennberg, 2007 | Prospective (nested) case-control | Sweden | Erythrocyte mercury | Stroke | 369 | RR = 0.99 (0.93, 1.06) in men; RR = 1.00 (0.94, 1.08) in women |
Systemic Effects |
Antioxidant defense against free radicals and reactive oxygen species |
Decreased lipid peroxidation |
Protection against vascular damage from oxidized LDL cholesterol particles |
Antithrombotic effects from decreased plasma thromboxane A2 |
Direct Cardiovascular Effects |
Increased myocardial antioxidant glutathione peroxidase activity |
Improved cardiac recovery from ischemia-reperfusion injury |
Limitation of ischemia-induced and diabetes-induced ultrastructural damage |
Reduction in myocardial infarct size |
Restoration of altered myocyte ion currents |
Reduced incidence of ischemia-induced ventricular arrhythmias |
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Mozaffarian, D. Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions. Int. J. Environ. Res. Public Health 2009, 6, 1894-1916. https://doi.org/10.3390/ijerph6061894
Mozaffarian D. Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions. International Journal of Environmental Research and Public Health. 2009; 6(6):1894-1916. https://doi.org/10.3390/ijerph6061894
Chicago/Turabian StyleMozaffarian, Dariush. 2009. "Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions" International Journal of Environmental Research and Public Health 6, no. 6: 1894-1916. https://doi.org/10.3390/ijerph6061894