ArticleEnvironmental health perspectives2010
Relationship between tap water hardness, magnesium, and calcium concentration and mortality due to ischemic heart disease or stroke in The Netherlands.
Article in Environmental health perspectives, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Magnesium Levels in Drinking Water and Coronary Heart Disease Mortality Risk: A Meta-Analysis.Nutrients · 2016Pooled it
- Associations Between Domestic Water Hardness, Genetic Risk and Severe MASLD: A Large-Scale Cohort Study.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Association between drinking water hardness and incidence of hospitalization for childhood fracture: an ecological study of England.JBMR plus · 2026Article
- Association Between Living Environmental Factors and Stroke in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.Journal of the American Heart Association · 2026Article
- Calcium Ion Sensors with Unrivaled Stability and Selectivity Using a Bilayer Approach with Ionically Imprinted Nanocomposites.Nanomaterials (Basel, Switzerland) · 2025Article
- Domestic water hardness, genetic risk, and distinct phenotypes of cardiovascular disease.Environmental health : a global access science source · 2025Article
- Evaluation of the Relationship Between Water Hardness and Incidence of Cardiovascular Diseases in Mashhad, Iran During 2018-2020: A Cross-Sectional Study.Health science reports · 2025Article
- The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review.Nutrients · 2024Review
- Mediatory role of the serum mineral level and discharge disability of stroke survivors.Caspian journal of internal medicine · 2024Article
- The Relationship between Mortality from Cardiovascular Diseases and Total Drinking Water Hardness: Systematic Review with Meta-Analysis.Foods (Basel, Switzerland) · 2023Review
- Calcium and magnesium in drinking water and risk of myocardial infarction and stroke-a population-based cohort study.The American journal of clinical nutrition · 2022Article
- The Risk of CVDs from Desalinated Seawater: A Nested Case-Control Study.International journal of environmental research and public health · 2022Article
- Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015.Environmental health : a global access science source · 2021Article
- Environmental heavy metals and cardiovascular diseases: Status and future direction.Chronic diseases and translational medicine · 2020Review
- Production of Vegetables and Artichokes Is Associated with Lower Cardiovascular Mortality: An Ecological Study.International journal of environmental research and public health · 2020Article
- Bioluminescent Ratiometric Indicator for Analysis of Water Hardness in Household Water.Sensors (Basel, Switzerland) · 2020Article
- Water hardness zoning of Isfahan Province, Iran, and its relationship with cardiovascular mortality, 2013-2015.ARYA atherosclerosis · 2019Article
- Intake of Molecular Hydrogen in Drinking Water Increases Membrane Transporters,Molecules (Basel, Switzerland) · 2019Article
- Association of consumption of excess hard water, body mass index and waist circumference with risk of hypertension in individuals living in hard and soft water areas.Environmental geochemistry and health · 2019Article
- Dietary Intake of Magnesium or Calcium and Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer Patients.Nutrients · 2018Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConflicting results on the relationship between the hardness of drinking water and mortality related to ischemic heart disease (IHD) or stroke have been reported.
objectivesWe investigated the possible association between tap water calcium or magnesium concentration and total hardness and IHD mortality or stroke mortality.
methodsIn 1986, a cohort of 120,852 men and women aged 5569 years provided detailed information on dietary and other lifestyle habits. Follow-up for mortality until 1996 was established by linking data from the Central Bureau of Genealogy and Statistics Netherlands. We calculated tap water hardness for each postal code using information obtained from all pumping stations in the Netherlands. Tap water hardness was categorized as soft [< 1.5 mmol/L calcium carbonate (CaCO3)], medium hard (1.62.0 mmol/L CaCO3), and hard (> 2.0 mmol/L CaCO3). The multivariate case-cohort analysis was based on 1,944 IHD mortality and 779 stroke mortality cases and 4,114 subcohort members.
resultsFor both men and women, we observed no relationship between tap water hardness and IHD mortality [hard vs. soft water: hazard ratio (HR) = 1.03; 95% confidence interval (CI), 0.851.28 for men and HR = 0.93; 95% CI, 0.711.21 for women) and stroke mortality (hard vs. soft water HR = 0.90; 95% CI, 0.661.21 and HR = 0.86; 95% CI, 0.621.20, respectively). For men with the 20% lowest dietary magnesium intake, an inverse association was observed between tap water magnesium intake and stroke mortality (HR per 1 mg/L intake = 0.75; 95% CI, 0.610.91), whereas for women with the 20% lowest dietary magnesium intake, the opposite was observed.
conclusionsWe found no evidence for an overall significant association between tap water hardness, magnesium or calcium concentrations, and IHD mortality or stroke mortality. More research is needed to investigate the effect of tap water magnesium on IHD mortality or stroke mortality in subjects with low dietary magnesium intake.
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