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Cadmium in Diet and Risk of Cardiovascular Disease in Women

Julin, Bettinaa; Bergkvist, Charlotteb; Wolk, Alicjaa; Åkesson, Agnetaa

doi: 10.1097/EDE.0b013e3182a777c9

Background: The toxic metal cadmium is suggested to increase the risk of cardiovascular disease, but only one incidence study has explored this association. We evaluated the association between quartiles of food frequency questionnaire–based estimates of cadmium exposure from food (the predominant source of exposure to the metal) and incident cardiovascular disease and its subtypes.

Methods: From the population-based Swedish Mammography cohort, 33,333 women were followed prospectively from baseline (1997) through 2010. We estimated relative risks (RRs) with 95% confidence intervals (CIs) using Cox proportional hazard models.

Results: During 12 years of follow-up, we identified 3155 incident cases of total cardiovascular disease (1322 cases of myocardial infarction and 1833 cases of total stroke [1485 ischemic and 208 hemorrhagic stroke]). Dietary cadmium exposure was not associated with risk of total cardiovascular disease, myocardial infarction, or total stroke or its subtypes. For total cardiovascular disease, the multivariable-adjusted RR comparing the highest quartile of cadmium exposure with the lowest was 0.96 (95% CI = 0.85–1.09). The corresponding RRs were 1.07 (0.88–1.29) for myocardial infarction, 0.90 (0.76–1.05) for total stroke, 0.89 (0.74–1.06) for ischemic stroke, and 1.11 (0.68–1.80) for hemorrhagic stroke.

Conclusions: Our study lends no support to an overall association between low-level exposure to cadmium via food and incident cardiovascular disease.

From the aInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and bEuropean Food Safety Authority, Parma, Italy.

This work was supported by the Swedish Council for Working Life and Social Research and the Swedish Research Council/Medicine and Infrastructures.

The authors declare no conflicts of interest.

Correspondence: Bettina Julin, Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden. E-mail:

Received February 8, 2013

Accepted June 1, 2013

© 2013 by Lippincott Williams & Wilkins, Inc