SynthesisInternational journal of epidemiology2017
A dose-response meta-analysis of chronic arsenic exposure and incident cardiovascular disease.
Synthesis in International journal of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 76 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 12 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Unsafe drinking water and human health: A global umbrella review of disease outcomes, intervention effectiveness, and policy implications.Cell reports. Medicine · 2026Pooled it
- Toxic heavy metal exposure and heart health: a systematic review and meta-analysis of 324,331 patients.BMC cardiovascular disorders · 2025Pooled it
- Optimal Dose of Baclofen for the Treatment of Alcohol Use Disorder: A Systematic Review and Dose-Response Meta-analysis.CNS drugs · 2025Pooled it
- "Low-to-moderate arsenic exposure: a global systematic review of cardiovascular disease risks".Environmental health : a global access science source · 2025Pooled it
- Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis.Environmental science and pollution research international · 2022Pooled it
- Provision of folic acid for reducing arsenic toxicity in arsenic-exposed children and adults.The Cochrane database of systematic reviews · 2021Pooled it
- Urinary arsenic and heart disease mortality in NHANES 2003-2014.Environmental research · 2021Pooled it
- Bayesian hierarchical dose-response meta-analysis of epidemiological studies: Modeling and target population prediction methods.Environment international · 2020Pooled it
- Toxic metal exposure as a possible risk factor for COVID-19 and other respiratory infectious diseases.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2020Pooled it
- Systematic dose-response of environmental epidemiologic studies: Dose and response pre-analysis.Environment international · 2020Pooled it
- Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2018Pooled it
- Influence of folic acid and vitamin B12 supplementation on arsenic methylation: A double-blinded, placebo-controlled trial in Bangladeshi children.Environment international · 2024Trial
- Interpretable Machine Learning in Heavy Metal-Associated Cardiovascular and Metabolic Disease: A Review of Current Methodologies, Toxicological Insights, and Clinical Implications.Cardiovascular toxicology · 2026Review
- 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
- Essential and Toxic Elements in Cardiovascular Disease: Pathophysiological Roles and the Emerging Contribution of Hair Mineral Analysis.International journal of molecular sciences · 2025Review
- The modifying effect of dietary index for gut microbiota on the association between urinary arsenic exposure and bladder cancer risk: a nationwide cohort study.Frontiers in nutrition · 2025Article
- A Feasibility Study to Mitigate Arsenic Exposure in Well Water in Oregon.Journal of extension · 2025Article
- Investigation of the relationship between lead exposure in heavy metals mixtures and the prevalence of stroke: a cross-sectional study.BMC public health · 2024Article
- Long-Term Exposure to Arsenic in Community Water Supplies and Risk of Cardiovascular Disease among Women in the California Teachers Study.Environmental health perspectives · 2024Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 11 institutions in 3 countries.
Funding
Abstract
Background: Consistent evidence at high levels of water arsenic (≥100 µg/l), and growing evidence at low-moderate levels (<100 µg/l), support a link with cardiovascular disease (CVD). The shape of the dose-response across low-moderate and high levels of arsenic in drinking water is uncertain and critical for risk assessment. Methods: We conducted a systematic review of general population epidemiological studies of arsenic and incident clinical CVD (all CVD, coronary heart disease (CHD) and stroke) with three or more exposure categories. In a dose-response meta-analysis, we estimated the pooled association between log-transformed water arsenic (log-linear) and restricted cubic splines of log-transformed water arsenic (non-linear) and the relative risk of each CVD endpoint. Results: Twelve studies (pooled N = 408 945) conducted at high (N = 7) and low-moderate (N = 5) levels of water arsenic met inclusion criteria, and 11 studies were included in the meta-analysis. Compared with 10 µg/l, the estimated pooled relative risks [95% confidence interval (CI)] for 20 µg/l water arsenic, based on a log-linear model, were 1.09 (1.03, 1.14) (N = 2) for CVD incidence, 1.07 (1.01, 1.14) (N = 6) for CVD mortality, 1.11 (1.05, 1.17) (N = 4) for CHD incidence, 1.16 (1.07, 1.26) (N = 6) for CHD mortality, 1.08 (0.99, 1.17) (N = 2) for stroke incidence and 1.06 (0.93, 1.20) (N = 6) for stroke mortality. We found no evidence of non-linearity, although these tests had low statistical power. Conclusions: Although limited by the small number of studies, this analysis supports quantitatively including CVD in inorganic arsenic risk assessment, and strengthens the evidence for an association between arsenic and CVD across low-moderate to high levels.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.