陳建仁2006-07-252018-06-292006-07-252018-06-292005-07-31http://ntur.lib.ntu.edu.tw//handle/246246/4703Context Chronic arsenic exposure has been found to increase the risk of atherosclerotic diseases. Previous studies were limited by ecological correlation, or cross-sectional studies and a small number of cases. Objectives To elucidate the dose-response relationship between ingested arsenic and cardiovascular mortality in a large-scale follow-up study. Design, Setting, and Participants This study enrolled 10,133 and 16,718 residents aged 40 and older from arsenic-exposed and unexposed areas respectively for an average follow up period of 12 years. Traditional risk factors and arsenic exposure via drinking water were evaluated through health examination and structured questionnaire interview. Main Outcome Measure Deaths from ischemic heart disease and stroke were ascertained up to December 31, 2004 through linkage with national death certification profiles. Cox's proportional hazards regression analyses were used to estimate multivariate-adjusted relative risks of mortality. Results There were 109,490 and 207,205 person-years observed for exposed and unexposed cohorts, respectively. There was a significant dose-response relationship between the mortality from ischemic artery disease and stroke and the arsenic level in drinking water (P<0.001 trend test). The relative risk was 1.80 (95% confidence interval, 1.36 –2.38) for the highest arsenic level compared with the lowest. Conclusions There was a significant dose-response relationship between the cardiovascular mortality and the arsenic level in drinking water. Arsenic is a dominant risk factor for cardiovascular mortality.application/pdf442085 bytesapplication/pdfzh-TW國立臺灣大學公共衛生學院流行病學研究所arsenicischemic heart diseasestrokerisk factorsreporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/4703/1/932320B002010.pdf