Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015

Background: Atrial fibrillation (AF) is a common heart rhythm disorder and a risk factor of adverse cardiovascular diseases. Established causes do not fully explain the risk of AF and unexplained risk factors might be related to the environment, e.g. magnesium in drinking water. Low magnesium levels...

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Autores: Wodschow, Kirstine, Villanueva Belmonte, Cristina, Larsen, Mogens Lytken, Gislason, Gunnar, Schullehner, Jörg, Hansen, Birgitte, Ersbøll, Annette Kjær
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/53072
Acesso em linha:http://hdl.handle.net/10230/53072
http://dx.doi.org/10.1186/s12940-021-00813-z
Access Level:acceso abierto
Palavra-chave:Atrial fibrillation
Cohort
Drinking water
Magnesium level
Registers
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oai_identifier_str oai:repositori.upf.edu:10230/53072
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
title Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
spellingShingle Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
Wodschow, Kirstine
Atrial fibrillation
Cohort
Drinking water
Magnesium level
Registers
title_short Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
title_full Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
title_fullStr Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
title_full_unstemmed Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
title_sort Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015
dc.creator.none.fl_str_mv Wodschow, Kirstine
Villanueva Belmonte, Cristina
Larsen, Mogens Lytken
Gislason, Gunnar
Schullehner, Jörg
Hansen, Birgitte
Ersbøll, Annette Kjær
author Wodschow, Kirstine
author_facet Wodschow, Kirstine
Villanueva Belmonte, Cristina
Larsen, Mogens Lytken
Gislason, Gunnar
Schullehner, Jörg
Hansen, Birgitte
Ersbøll, Annette Kjær
author_role author
author2 Villanueva Belmonte, Cristina
Larsen, Mogens Lytken
Gislason, Gunnar
Schullehner, Jörg
Hansen, Birgitte
Ersbøll, Annette Kjær
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Atrial fibrillation
Cohort
Drinking water
Magnesium level
Registers
topic Atrial fibrillation
Cohort
Drinking water
Magnesium level
Registers
description Background: Atrial fibrillation (AF) is a common heart rhythm disorder and a risk factor of adverse cardiovascular diseases. Established causes do not fully explain the risk of AF and unexplained risk factors might be related to the environment, e.g. magnesium in drinking water. Low magnesium levels in drinking water might be associated with higher risk of cardiovascular diseases including AF. With detailed individual data from nationwide registries and long-term magnesium exposure time series, we had a unique opportunity to investigate the association between magnesium in drinking water and AF. Objective: We evaluated the association between magnesium concentration in drinking water and AF risk. Methods: A nationwide register-based cohort study (2002-2015) was used including individuals aged ≥30 years. Addresses were linked with water supply areas (n = 2418) to obtain time-varying drinking water magnesium exposure at each address. Five exposure groups were defined based on a 5-year rolling time-weighted average magnesium concentration. AF incidence rate ratios (IRRs) between exposure groups were calculated using a Poisson regression of incidence rates, adjusted for sex, age, and socioeconomic position. Robustness of results was investigated with different exposure definitions. Results: The study included 4,264,809 individuals (44,731,694 person-years) whereof 222,998 experienced an incident AF. Magnesium exposure ranged from 0.5 to 62.0 mg/L (mean = 13.9 mg/L). Estimated IRR (95% CI) compared to the referent exposure group (< 5 mg/L) was 0.98 (0.97-1.00) for the second lowest exposure group (5-10 mg/L), and 1.07 (1.05-1.08) for the two highest exposure groups (15-62 mg/L). Strongest positive associations were observed among those aged ≥80 years and with lowest education group. An inverse association was found among individuals with highest education group. Conclusion: There might be a small beneficial effect on AF of an increase in magnesium level in drinking water up to 10 mg/L, though an overall positive association was observed. The unexpected positive association and different associations observed for subgroups suggest a potential influence of unaccounted factors, particularly in vulnerable populations. Future research on magnesium in drinking water and cardiovascular diseases needs to focus on contextual risk factors, especially those potentially correlating with magnesium in drinking water.
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/53072
http://dx.doi.org/10.1186/s12940-021-00813-z
url http://hdl.handle.net/10230/53072
http://dx.doi.org/10.1186/s12940-021-00813-z
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Environ Health. 2021 Dec 15;20(1):126
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Association between magnesium in drinking water and atrial fibrillation incidence: a nationwide population-based cohort study, 2002-2015Wodschow, KirstineVillanueva Belmonte, CristinaLarsen, Mogens LytkenGislason, GunnarSchullehner, JörgHansen, BirgitteErsbøll, Annette KjærAtrial fibrillationCohortDrinking waterMagnesium levelRegistersBackground: Atrial fibrillation (AF) is a common heart rhythm disorder and a risk factor of adverse cardiovascular diseases. Established causes do not fully explain the risk of AF and unexplained risk factors might be related to the environment, e.g. magnesium in drinking water. Low magnesium levels in drinking water might be associated with higher risk of cardiovascular diseases including AF. With detailed individual data from nationwide registries and long-term magnesium exposure time series, we had a unique opportunity to investigate the association between magnesium in drinking water and AF. Objective: We evaluated the association between magnesium concentration in drinking water and AF risk. Methods: A nationwide register-based cohort study (2002-2015) was used including individuals aged ≥30 years. Addresses were linked with water supply areas (n = 2418) to obtain time-varying drinking water magnesium exposure at each address. Five exposure groups were defined based on a 5-year rolling time-weighted average magnesium concentration. AF incidence rate ratios (IRRs) between exposure groups were calculated using a Poisson regression of incidence rates, adjusted for sex, age, and socioeconomic position. Robustness of results was investigated with different exposure definitions. Results: The study included 4,264,809 individuals (44,731,694 person-years) whereof 222,998 experienced an incident AF. Magnesium exposure ranged from 0.5 to 62.0 mg/L (mean = 13.9 mg/L). Estimated IRR (95% CI) compared to the referent exposure group (< 5 mg/L) was 0.98 (0.97-1.00) for the second lowest exposure group (5-10 mg/L), and 1.07 (1.05-1.08) for the two highest exposure groups (15-62 mg/L). Strongest positive associations were observed among those aged ≥80 years and with lowest education group. An inverse association was found among individuals with highest education group. Conclusion: There might be a small beneficial effect on AF of an increase in magnesium level in drinking water up to 10 mg/L, though an overall positive association was observed. The unexpected positive association and different associations observed for subgroups suggest a potential influence of unaccounted factors, particularly in vulnerable populations. Future research on magnesium in drinking water and cardiovascular diseases needs to focus on contextual risk factors, especially those potentially correlating with magnesium in drinking water.BioMed Central202220222021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/53072http://dx.doi.org/10.1186/s12940-021-00813-zreponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésEnviron Health. 2021 Dec 15;20(1):126© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/530722026-06-12T07:21:37Z
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