Arsenic in Drinking Water Alters Heart Structure

Arsenic-contaminated drinking water can potentially lead to thickening of the heart muscle, new study results indicate.

“People drinking water from private wells, which are not regulated, need to be aware that arsenic may increase the risk for cardiovascular disease. Testing those wells is a critical first step to take action and prevent exposure,” said Gernot Pichler, MD, PhD, MSc, lead author of the study and medical specialist for Internal Medicine, Department of Cardiology at Hospital Hietzing/Heart Center Clinic Floridsdorf in Vienna, Austria, said in an AHA press release about the study. The paper, published in Circulation: Cardiovascular Imaging, specifically looked at the cross-sectional association between arsenic exposure and left ventricular geometry and function.

The study included 1,337 young adult participants from the Strong Heart Family Study who were free of diabetes and cardiovascular disease. The researchers measured the sum of inorganic and methylated arsenic concentrations (ΣAs) in participant urine at baseline, and transthoracic echocardiography for the assessment of left ventricular function at baseline and follow-up. Mean follow-up was 5.6 years.

According to the results, increased arsenic exposure was linked to prevalent left ventricular hypertrophy (OR=1.47 in all participants and 1.58 in prehypertensive/hypertensive participants). Arsenic exposure, according to the authors, significantly correlated with many measures of left ventricular function, including left ventricular mass index, left atrial systolic diameter, interventricular septum, and left ventricular posterior wall thickness. Stroke volume and ejection fraction were also associated with arsenic exposure.

“Arsenic exposure was related to an increase in left ventricular wall thickness and left ventricular hypertrophy in young American Indians with a low burden of cardiovascular risk factors,” the authors of the study wrote in their conclusion. “The relationship was stronger in participants with prehypertension or hypertension, suggesting that potential cardiotoxic effects of arsenic might be more pronounced in individuals already undergoing cardiovascular adaptive mechanisms following elevated systemic blood pressure.”

A Global Problem

In an accompanying editorial, Rajiv Chowdhury, MBBS, PhD, and Kim van Daalen, BSc, MPhil, emphasized the global nature of the problem of arsenic-contaminated drinking water.

“In the past decades, exposure to environmental metal contaminants (eg, arsenic, lead, cadmium, and mercury) through groundwater, food, soil, and ambient air, has become a global public health concern,” they wrote. “In this regard, aresnic–one of the most abundant environmental metals worldwide–affects >200 million people in >70 countries solely by drinking water route.”