Sicheng Li, Hanwen Zhou, Jiajin Chen, Wenpan Xian, Yuqin Zhang, Yan Wang
{"title":"生活用水硬度与经历15种不同心血管事件的风险之间的关系：一项对324,136名英国生物银行参与者的前瞻性队列研究。","authors":"Sicheng Li, Hanwen Zhou, Jiajin Chen, Wenpan Xian, Yuqin Zhang, Yan Wang","doi":"10.1016/j.ajcnut.2025.10.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated domestic water hardness (DWH)-cardiovascular disease (CVD) associations, but the results are inconsistent, and investigations of specific CVD subtypes are scarce.</p><p><strong>Objective: </strong>We aimed to investigate the individual and combined associations of DWH with CVD and its subtypes.</p><p><strong>Methods: </strong>This cohort study included UK Biobank participants whose address codes were used to obtain DWH data (calcium carbonate [CaCO<sub>3</sub>], calcium [Ca], and magnesium [Mg]) from water supply companies. Incident CVD events were identified via International Classification of Diseases-Tenth Revision codes. The individual and combined associations between DWH exposure and incident CVD events were evaluated via Cox proportional hazards regression and quantile G-computation, respectively.</p><p><strong>Results: </strong>During a median follow-up period of over 13.41 years, 5,780 CVD deaths and 60,184 CVD cases were identified among 324,136 participants (mean±standard deviation age=55.76±8.08 years; female proportion=53.95%). U-shaped associations were observed between CaCO<sub>3</sub> and CVD death (P-nonlinear=0.024) and between Ca and CVD (P-nonlinear=0.008). Each log-transformed Mg interquartile range increase was associated with decreased CVD risk (hazard ratio [HR]=0.978, 95% confidence interval [CI]=0.961‒0.996). DWH was linearly and nonlinearly associated with seven CVD subtypes (chronic rheumatic heart diseases, ischemic heart diseases, nonrheumatic valve disease, myocarditis and cardiomyopathy, arrhythmias, heart failure, and cerebral infarction). Combined DWH exposure was associated with increased chronic rheumatic heart disease risk (HR=1.070, 95% CI=1.011‒1.133), with Mg having the largest negative weight of 1.000 and Ca having the largest positive weight of 0.908.</p><p><strong>Conclusions: </strong>DWH was associated with cardiovascular health, including nine CVD events. Specifically, higher concentrations of Mg and moderate levels of CaCO<sub>3</sub> and Ca were associated with lower CVD risk. Combined DWH was associated with increased chronic rheumatic heart disease risk.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9000,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations between domestic water hardness and the risk of experiencing fifteen different cardiovascular events: A prospective cohort study of 324,136 UK Biobank participants.\",\"authors\":\"Sicheng Li, Hanwen Zhou, Jiajin Chen, Wenpan Xian, Yuqin Zhang, Yan Wang\",\"doi\":\"10.1016/j.ajcnut.2025.10.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies have demonstrated domestic water hardness (DWH)-cardiovascular disease (CVD) associations, but the results are inconsistent, and investigations of specific CVD subtypes are scarce.</p><p><strong>Objective: </strong>We aimed to investigate the individual and combined associations of DWH with CVD and its subtypes.</p><p><strong>Methods: </strong>This cohort study included UK Biobank participants whose address codes were used to obtain DWH data (calcium carbonate [CaCO<sub>3</sub>], calcium [Ca], and magnesium [Mg]) from water supply companies. Incident CVD events were identified via International Classification of Diseases-Tenth Revision codes. The individual and combined associations between DWH exposure and incident CVD events were evaluated via Cox proportional hazards regression and quantile G-computation, respectively.</p><p><strong>Results: </strong>During a median follow-up period of over 13.41 years, 5,780 CVD deaths and 60,184 CVD cases were identified among 324,136 participants (mean±standard deviation age=55.76±8.08 years; female proportion=53.95%). U-shaped associations were observed between CaCO<sub>3</sub> and CVD death (P-nonlinear=0.024) and between Ca and CVD (P-nonlinear=0.008). Each log-transformed Mg interquartile range increase was associated with decreased CVD risk (hazard ratio [HR]=0.978, 95% confidence interval [CI]=0.961‒0.996). DWH was linearly and nonlinearly associated with seven CVD subtypes (chronic rheumatic heart diseases, ischemic heart diseases, nonrheumatic valve disease, myocarditis and cardiomyopathy, arrhythmias, heart failure, and cerebral infarction). Combined DWH exposure was associated with increased chronic rheumatic heart disease risk (HR=1.070, 95% CI=1.011‒1.133), with Mg having the largest negative weight of 1.000 and Ca having the largest positive weight of 0.908.</p><p><strong>Conclusions: </strong>DWH was associated with cardiovascular health, including nine CVD events. Specifically, higher concentrations of Mg and moderate levels of CaCO<sub>3</sub> and Ca were associated with lower CVD risk. Combined DWH was associated with increased chronic rheumatic heart disease risk.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.9000,\"publicationDate\":\"2025-10-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.10.004\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.10.004","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Associations between domestic water hardness and the risk of experiencing fifteen different cardiovascular events: A prospective cohort study of 324,136 UK Biobank participants.
Background: Previous studies have demonstrated domestic water hardness (DWH)-cardiovascular disease (CVD) associations, but the results are inconsistent, and investigations of specific CVD subtypes are scarce.
Objective: We aimed to investigate the individual and combined associations of DWH with CVD and its subtypes.
Methods: This cohort study included UK Biobank participants whose address codes were used to obtain DWH data (calcium carbonate [CaCO3], calcium [Ca], and magnesium [Mg]) from water supply companies. Incident CVD events were identified via International Classification of Diseases-Tenth Revision codes. The individual and combined associations between DWH exposure and incident CVD events were evaluated via Cox proportional hazards regression and quantile G-computation, respectively.
Results: During a median follow-up period of over 13.41 years, 5,780 CVD deaths and 60,184 CVD cases were identified among 324,136 participants (mean±standard deviation age=55.76±8.08 years; female proportion=53.95%). U-shaped associations were observed between CaCO3 and CVD death (P-nonlinear=0.024) and between Ca and CVD (P-nonlinear=0.008). Each log-transformed Mg interquartile range increase was associated with decreased CVD risk (hazard ratio [HR]=0.978, 95% confidence interval [CI]=0.961‒0.996). DWH was linearly and nonlinearly associated with seven CVD subtypes (chronic rheumatic heart diseases, ischemic heart diseases, nonrheumatic valve disease, myocarditis and cardiomyopathy, arrhythmias, heart failure, and cerebral infarction). Combined DWH exposure was associated with increased chronic rheumatic heart disease risk (HR=1.070, 95% CI=1.011‒1.133), with Mg having the largest negative weight of 1.000 and Ca having the largest positive weight of 0.908.
Conclusions: DWH was associated with cardiovascular health, including nine CVD events. Specifically, higher concentrations of Mg and moderate levels of CaCO3 and Ca were associated with lower CVD risk. Combined DWH was associated with increased chronic rheumatic heart disease risk.
期刊介绍：
American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism.
Purpose:
The purpose of AJCN is to:
Publish original research studies relevant to human and clinical nutrition.
Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits.
Encourage public health and epidemiologic studies relevant to human nutrition.
Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches.
Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles.
Peer Review Process:
All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.
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