Blackfoot Disease Status
In a cohort study of ischemic heart disease among residents in the BFD-endemic area, a significant biological gradient was observed between the incidence of ischemic heart disease and the cumulative arsenic exposure (Chen et al., 1996). There was also an increased incidence of ischemic heart disease for patients affected with BFD as compared with the unaffected. The status of BFD may be considered an indicator of long-term arsenic exposure, systemic atherosclerosis and/or susceptibility to arseniasis. The association between BFD and ischemic heart disease remained significant after adjustment for cumulative arsenic exposure and other risk factors, showing a multivariate-adjusted relative risk of 2.5.
In a recent case-control study on ischemic heart disease in arseniasis-hyperendemic villages (Hsueh et al., 1998), serum samples of 74 patients and 193 matched healthy controls were tested for serum levels of micronutrients by HPLC. A significant reverse dose-response relationship with arsenic-induced ischemic heart disease was observed for serum levels of a- and P-carotene, but not for serum levels of retinal, lycopene and a-tocopherol. The odds ratio of developing ischemic heart disease for those with a serum a- and P-carotene level < 8.7 Mg/dl and a duration of consuming artesian well water >13 years was around five-fold, compared with those that had a serum a- and P-carotene level > 8.7 Mg/dl and a duration of consuming artesian well water <13 years, after adjustment for age, sex, body mass index, ratio between total cholesterol and HDL cholesterol, and hypertension.
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