Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/44605
Title: Mercury exposure and risk of cardiovascular disease: a nested case-control study in the PREDIMED (PREvention with MEDiterranean Diet) study
Authors: Downer, Mary K.
Martínez-González, Miguel A.
Gea, Alfredo
Stampfer, Meir
Warnberg, Julia
Ruiz-Canela, Miguel
Salas-Salvadó, Jordi
Corella, Dolores
Ros, Emilio
Fitó, Montse
Estruch, Ramon
Arós, Fernando
Fiol, Miquel
Lapetra, José
Serra-Majem, Lluís 
Bullo, Monica
Sorli, Jose V.
Muñoz, Miguel A.
García-Rodriguez, Antonio
Gutierrez-Bedmar, Mario
Gómez-Gracia, Enrique
UNESCO Clasification: 320501 Cardiología
3206 Ciencias de la nutrición
Keywords: Coronary-Heart-Disease
Food-Frequency Questionnaire
Meat Consumption
Human Health
Fish Intake
Methylmercury Exposure
Myocardial-Infarction
Mortality
Men
Patterns
Mercury
Fish
Cardiovascular Disease
Mediterranean Diet
Predimed
Toenail Biomarker
Issue Date: 2017
Project: Red Alimentación Saludable en la Prevención Primaria de Enfermedades Crónicas: la Red Predimed. (Retics 2006) 
Journal: BMC Cardiovascular Disorders 
Abstract: Background: Substantial evidence suggests that consuming 1-2 servings of fish per week, particularly oily fish (e.g., salmon, herring, sardines) is beneficial for cardiovascular health due to its high n-3 polyunsaturated fatty acid content. However, there is some concern that the mercury content in fish may increase cardiovascular disease risk, but this relationship remains unclear. Methods: The PREDIMED trial included 7477 participants who were at high risk for cardiovascular disease at baseline. In this study, we evaluated associations between mercury exposure, fish consumption and cardiovascular disease. We randomly selected 147 of the 288 cases diagnosed with cardiovascular disease during follow-up and matched them on age and sex to 267 controls. Instrumental neutron activation analysis was used to assess toenail mercury concentration. In-person interviews, medical record reviews and validated questionnaires were used to assess fish consumption and other covariates. Information was collected at baseline and updated yearly during follow-up. We used conditional logistic regression to evaluate associations in the total nested case-control study, and unconditional logistic regression for population subsets. Results: Mean (±SD) toenail mercury concentrations (μg per gram) did not significantly differ between cases (0.63 (±0.53)) and controls (0.67 (±0.49)). Mercury concentration was not associated with cardiovascular disease in any analysis, and neither was fish consumption or n-3 fatty acids. The fully-adjusted relative risks for the highest versus lowest quartile of mercury concentration were 0.71 (95% Confidence Interval [CI], 0.34, 1.14; ptrend=0.37) for the nested case-control study, 0.74 (95% CI, 0.32, 1.76; ptrend=.43) within the Mediterranean diet intervention group, and 0.50 (95% CI, 0.13, 1.96; ptrend=0.41) within the control arm of the trial. Associations remained null when mercury was jointly assessed with fish consumption at baseline and during follow-up. Results were similar in different sensitivity analyses. Conclusions: We found no evidence that mercury exposure from regular fish consumption increases cardiovascular disease risk in a population of Spanish adults with high cardiovascular disease risk and high fish consumption. This implies that the mercury content in fish does not detract from the already established cardiovascular benefits of fish consumption.
URI: http://hdl.handle.net/10553/44605
ISSN: 1471-2261
DOI: 10.1186/s12872-016-0435-8
Source: Bmc Cardiovascular Disorders [ISSN 1471-2261], v. 17, (Enero 2017)
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