ArticleEnvironment international2022
The association of arsenic exposure and arsenic metabolism with all-cause, cardiovascular and cancer mortality in the Strong Heart Study.
Article in Environment international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.
What it found
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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.
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Who cites it
23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Metallomic Dysregulation and Cardiovascular Disease: Essential Trace Elements, Non-essential Metal Exposure, and Heart Failure Risk: A Systematic Review.Cardiovascular toxicology · 2026Pooled it
- Prediction of Emerging CVD Biomarkers in Population Exposed to Arsenic and Their Associated Risk Factors in Humans by Systematic Review and Meta-Analysis.Biological trace element research · 2026Pooled it
- Toxic heavy metal exposure and heart health: a systematic review and meta-analysis of 324,331 patients.BMC cardiovascular disorders · 2025Pooled it
- "Low-to-moderate arsenic exposure: a global systematic review of cardiovascular disease risks".Environmental health : a global access science source · 2025Pooled it
- Dietary interventions to reduce heavy metal exposure in antepartum and postpartum women: a systematic review.Women's health nursing (Seoul, Korea) · 2024Pooled it
- Effect of an Arsenic Mitigation Program on Arsenic Exposure in American Indian Communities: A Cluster Randomized Controlled Trial of the Community-Led Strong Heart Water Study Program.Environmental health perspectives · 2024Trial
- Article
- The Role of the cGAS/STING Pathway in Arsenic-Induced Neurotoxicity: Insights from the Crosstalk Between Astrocytes and Neurons.Biological trace element research · 2025Article
- Improving Cardiovascular Health Through the Consideration of Social Factors in Genetics and Genomics Research: A Scientific Statement From the American Heart Association.Circulation. Cardiovascular quality and outcomes · 2025Review
- Initiating Research in Indian Country: Lessons From the Strong Heart Study.Preventing chronic disease · 2025Article
- Arsenic Exposure During Pregnancy and Childhood: Factors Explaining Changes over a Decade.Toxics · 2025Article
- The role of DAAO in cognitive impairment of offspring mice induced by arsenic exposure during early developmental stage.PloS one · 2025Article
- Arsenic toxicity in theFrontiers in toxicology · 2025Article
- 2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part I.Acta Cardiologica Sinica · 2024Article
- Invited Perspective: The Importance of Community Involvement in Interventions to Reduce Arsenic Exposure and Improve Health Outcomes in Indigenous Communities.Environmental health perspectives · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Arsenic Exposure and Epigenetic Aging: The Association with Cardiovascular Disease and All-Cause Mortality in the Strong Heart Study.Environmental health perspectives · 2023Article
- Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina.Environmental health : a global access science source · 2023Article
- Metal mixtures and DNA methylation measures of biological aging in American Indian populations.Environment international · 2023Article
- Soil and water pollution and human health: what should cardiologists worry about?Cardiovascular research · 2023Review
Corrections and comments
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Authors and funding
7 authors at 7 institutions in 3 countries.
Funding
Abstract
The effect of low-moderate levels of arsenic exposure and of arsenic metabolism on mortality remains uncertain. We used data from a prospective cohort study in 3600 men and women aged 45 to 75 years living in Arizona, Oklahoma, and North and South Dakota. The biomarker of inorganic arsenic exposure was the sum of urine inorganic (iAs), monomethylated (MMA) and dimethylated (DMA) arsenic compounds (ƩAs) at baseline. The proportions of urine iAs, MMA and DMA over the ƩiAs, expressed as iAs%, MMA%, and DMA%, respectively, were used as biomarkers of arsenic metabolism. Arsenic exposure and arsenic metabolism were associated with all-cause, cardiovascular, and cancer mortality. For each interquartile range (IQR) increase in ƩAs (12.5 μg/L, overall range 0.7-194.1 μg/L), the adjusted hazard ratios (aHRs) were 1.28 (95% CI 1.16-1.41) for all-cause mortality, 1.28 (1.08-1.52) for cardiovascular mortality and 1.15 (0.92-1.44) for cancer mortality. The aHR for mortality for each IQR increase in MMA%, when iAs% is decreasing, was 1.52 (95% CI 1.16-1.99) for cardiovascular disease, 0.73 (0.55-0.98) for cancer, and 1.03 (0.90-1.19) for all-cause mortality. These findings at low-moderate levels of arsenic exposure highlight the need to implement public health measures to protect populations from involuntary arsenic exposure and for research to advance the biological and clinical understanding of arsenic-related health effects in general populations.
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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.