ArticleInternational journal of epidemiology2019
The association of urine metals and metal mixtures with cardiovascular incidence in an adult population from Spain: the Hortega Follow-Up Study.
Article in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers.
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Who cites it
60 citing papers in PubMed, 128 citations in OpenAlex.
- Emerging Inverse Association Between Low Exposure to Vanadium and Kidney Function Impairment: a Cross-Sectional Analysis of Japanese Residents.Biological trace element research · 2026Article
- Antimony: a cryptic metabolism disruptor ubiquitous in food contact materials.Journal of the Endocrine Society · 2026Review
- The role of coronary artery calcification in metal-related cardiovascular disease.Environment international · 2026Article
- Multiple-element exposure in early pregnancy and birth defects: a nested case-control study based on the China birth cohort study.Frontiers in nutrition · 2026Article
- Comparison of Methods for Analyzing Environmental Mixtures Effects on Survival Outcomes.Current environmental health reports · 2025Review
- Barium Levels in Brazil Nuts: A Global Review of the Literature.Journal of food science · 2025Review
- Metal Mixtures Mediate the Socioeconomic Gradient in Blood Pressure: A Four-Way Decomposition in a Prospective Rural Bangladeshi Cohort.medRxiv : the preprint server for health sciences · 2025Article
- Associations Between Urinary Metal Levels and Incident Heart Failure: A Multi-Cohort Analysis.JACC. Heart failure · 2025Article
- Curcumin nanoparticles ameliorates cardiac toxicity through modulation of oxidative stress, apoptosis, inflammation, and DNA damage in rat.Toxicology research · 2025Article
- Combined Effect of Metals, PFAS, Phthalates, and Plasticizers on Cardiovascular Disease Risk.Toxics · 2025Article
- Association of maternal multi-metal exposure and dyslipidemia: a study of air pollution on pregnancy outcomes.BMC pregnancy and childbirth · 2025Article
- Association Between Heavy Metals Mixtures and Life's Essential 8 Score in General US Adults.Cardiovascular toxicology · 2025Article
- Associations Between Lead and Cadmium Exposure and Subclinical Cardiovascular Disease in U.S. Adults.Cardiovascular toxicology · 2025Article
- Association between heavy metals and risk of cardiovascular diseases in US adults with prediabetes from NHANES 2011-2018.BMC public health · 2025Article
- Association between urinary metallothionein concentration and causes of death among cadmium-exposed residents in Japan: a 35-year follow-up study.Environmental health and preventive medicine · 2025Article
- Association between exposure to blood heavy metal mixtures and overactive bladder risk among U.S. adults: a cross-sectional study.Frontiers in public health · 2025Article
- Use of biomarkers of metals to improve prediction performance of cardiovascular disease mortality.Environmental health : a global access science source · 2024Article
- Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis.Journal of the American College of Cardiology · 2024Article
- Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA).Circulation · 2024Article
- Detecting univariate, bivariate, and overall effects of drug mixtures using Bayesian kernel machine regression.The American journal of drug and alcohol abuse · 2024Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundThe association of low-level exposure to metals and metal mixtures with cardiovascular incidence in the general population has rarely been studied. We flexibly evaluated the association of urinary metals and metal mixtures concentrations with cardiovascular diseases in a representative sample of a general population from Spain.
methodsUrine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured in 1171 adults without clinical cardiovascular diseases, who participated in the Hortega Study. Cox proportional hazard models were used for evaluating the association between single metals and cardiovascular incidence. We used a Probit extension of Bayesian Kernel Machine Regression (BKMR-P) to handle metal mixtures in a survival setting.
resultsIn single-metal models, the hazard ratios [confidence intervals (CIs)] of cardiovascular incidence, comparing the 80th to the 20th percentiles of metal distributions, were 1.35 (1.06, 1.72) for Cu, 1.43 (1.07, 1.90) for Zn, 1.51 (1.13, 2.03) for Sb, 1.46 (1.13, 1.88) for Cd, 1.64 (1.05, 2.58) for Cr and 1.31 (1.01, 1.71) for V. BKMR-P analysis was confirmatory of these findings, supporting that Cu, Zn, Sb, Cd, Cr and V are related to cardiovascular incidence in the presence of the other metals. Cd and Sb showed the highest posterior inclusion probabilities.
conclusionsUrine Cu, Zn, Sb, Cd, Cr and V were independently associated with increased cardiovascular risk at levels relevant for the general population of Spain. Urine metals in the mixture were also jointly associated with cardiovascular incidence, with Cd and Sb being the most important components of the mixture.
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