Urinary Metal Levels Tied to Increased Risk for Later Heart Failure
THURSDAY, July 3, 2025 -- There are consistent associations between elevated urinary metal levels and increased heart failure risk over time across geographically diverse cohorts of adults, according to a study published online June 17 in JACC: Heart Failure.
Irene Martinez-Morata, M.D., Ph.D., from the Columbia University Mailman School of Public Health in New York City, and colleagues evaluated the prospective association of urinary metals with incident heart failure. The analysis included participants (aged 18 to 85 years) across three geographically and ethnically and racially diverse cohorts: the Multi-Ethnic Study of Atherosclerosis (6,601 individuals) and Strong Heart Study (2,917 individuals) in the United States and the Hortega Study (1,300 individuals) in Spain.
The researchers found that during 20 years of follow-up, there were significant associations per doubling of urinary metal for cadmium (pooled hazard ratio [HR], 1.15), molybdenum (HR, 1.13), and zinc (HR, 1.22). The association of one interquartile range increase in the multimetal mixture (arsenic, cadmium, molybdenum, selenium, and zinc) levels trended to increased incident heart failure across each cohort in fully adjusted models. Results for stratified models by left ventricular ejection fraction were similar to the pooled results.
"Most previous studies have assessed individual metals in isolation," said Martinez-Morata in a statement. "By examining metals as a mixture, our analysis more closely reflects real-world exposure patterns."
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