Cardiovascular disease death rates in communities with elevated levels of barium in drinking water

Brenniman, Gary R.; Namekata, Tsukasa; Kojola, W.; Carnow, Bertram W.; Levy, Paul S.

doi:10.1016/0013-9351(79)90007-0

Cited by 43 publications

(17 citation statements)

References 7 publications

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“…Data on the possible role of these metals in atherosclerosis are scarce. Ecologic studies have found positive associations with cardiovascular disease for barium (Brenniman et al 1979) and thallium (Heim et al 2002) and a negative association for molybdenum (Guo et al 1992). Thallium is a poison at high dose (ATSDR 1992b).…”

Section: Discussionmentioning

confidence: 99%

“…Cadmium and lead have been associated with other cardiovascular end points, such as myocardial infarction and stroke, in some studies (Lustberg and Silbergeld 2002; Ponteva et al 1979) but not all (Pocock et al 1988; Staessen et al 1996). For several other metals, including barium, cobalt, molybdenum, antimony, and thallium, data on their role in human atherosclerosis are sparse (Brenniman et al 1979; Guo et al 1992; Heim et al 2002; Schnorr et al 1995). There are no epidemiologic data on the potential cardiovascular effects of cesium or tungsten.…”

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confidence: 99%

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Metals in Urine and Peripheral Arterial Disease

Navas‐Acien

Silbergeld

Sharrett

et al. 2005

Environ Health Perspect

197

150

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Exposure to metals may promote atherosclerosis. Blood cadmium and lead were associated with peripheral arterial disease (PAD) in the 1999–2000 National Health and Nutrition Examination Survey (NHANES). In the present study we evaluated the association between urinary levels of cadmium, lead, barium, cobalt, cesium, molybdenum, antimony, thallium, and tungsten with PAD in a cross-sectional analysis of 790 participants ≥40 years of age in NHANES 1999–2000. PAD was defined as a blood pressure ankle brachial index < 0.9 in at least one leg. Metals were measured in casual (spot) urine specimens by inductively coupled plasma–mass spectrometry. After multivariable adjustment, subjects with PAD had 36% higher levels of cadmium in urine and 49% higher levels of tungsten compared with noncases. The adjusted odds ratio for PAD comparing the 75th to the 25th percentile of the cadmium distribution was 3.05 [95% confidence interval (CI), 0.97 to 9.58]; that for tungsten was 2.25 (95% CI, 0.97 to 5.24). PAD risk increased sharply at low levels of antimony and remained elevated beyond 0.1 μg/L. PAD was not associated with other metals. In conclusion, urinary cadmium, tungsten, and possibly antimony were associated with PAD in a representative sample of the U.S. population. For cadmium, these results strengthen previous findings using blood cadmium as a biomarker, and they support its role in atherosclerosis. For tungsten and antimony, these results need to be interpreted cautiously in the context of an exploratory analysis but deserve further study. Other metals in urine were not associated with PAD at the levels found in the general population.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Metals in Urine and Peripheral Arterial Disease

Navas‐Acien

Silbergeld

Sharrett

et al. 2005

Environ Health Perspect

197

150

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“…Of course, water higher in barium tends to be higher in both calcium and magnesium (harder), so this finding may be confounded by other factors. In contrast, higher concentrations of barium (greater than 1 ppm), have been associated with higher cardiovascular mortality in one epidemiological study (10). An area of northern Illinois that has high drinking water barium concentrations (7-10 ppm) was compared with a nearby area that has low drinking water barium concentrations, and a higher cardiovascular death rate in the area with high barium concentrations was found.…”

Section: Introductionmentioning

confidence: 86%

Lack of Effect of Drinking Water Barium on Cardiovascular Risk Factors

Wones¹,

Stadler²,

Frohman³

1990

Environmental Health Perspectives

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Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels ofbarium in drinking water. The purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for cardiovascular disease. Eleven healthy men completed a 10-week dose-response protocol in which diet was controlled (600 mg cholesterol; 40 % fat, 40 % carbohydrate, 20 % protein; sodium and potassium controlled at the subject's pre-protocol estimated intake). Other aspects of the subjects' lifestyles known to affect cardiac risk factors were controlled, and the barium content (as barium chloride) of the drinking water (1.5 L/day) was varied from 0 (first 2 weeks), to 5 ppm (next 4 weeks), to 10 ppm (last 4 weeks). Multiple blood and urine samples, morning and evening blood pressure measurements, and 48-hr electrocardiographic monitoring were performed at each dose of barium. There were no changes in morning or evening systolic or diastolic blood pressures, plasma cholesterol or lipoprotein or apolipoprotein levels, serum potassium or glucose levels, or urine catecholamine levels. There were no arrythmias related to barium exposure detected on continuous electrocardiographic monitoring. A trend was seen toward increased total serum calcium levels with exposure to barium, which was of borderline statistical significance and of doubtful clinical significance. In summary, drinking water barium at levels of 5 and 10 ppm did not appear to affect any of the known modifiable cardiovascular risk factors.

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“…Signi"cant negative correlations between barium concentrations in drinking water and mortality from atherosclerotic heart disease (Schroeder and Kramer, 1974) and total cardiovascular disease (Elwood et al, 1974) have been reported. Conversely, signi"cantly higher sex-and age-adjusted death rates for &&all cardiovascular diseases'' and &&heart disease'' have been reported in an unspeci"ed number of Illinois communities with high concentrations of barium in drinking water (2}10 mg/L) as compared with those with low concentrations ((0.2 mg/L) in 1971}1975 (Brenniman, 1979).…”

Section: Figure 2 (Continued)mentioning

confidence: 93%