Eliseo Guallar

Chair and Professor of the Department of Epidemiology

Professional overview

Dr. Guallar is an epidemiologist whose research is focused on the study of cardiovascular disease epidemiology and prevention, with an emphasis on evaluating the role of environmental and nutritional exposures in the development of cardiovascular disease. This research has made critically important and novel contributions to our understanding of risk factors for chronic disease both in the US and globally. He has published seminal articles and is a leading figure in an emerging field highlighting the risks of exposure to levels of metals previously considered safe for cardiovascular health. In addition to his work in toxic metals, Dr. Guallar has made important contributions to understanding the effects of certain micronutrients and vitamin supplements on cardiovascular disease risk and outcomes. Publications in this area were influential in changing consumer habits and attitudes towards these products. Much of this research has been funded by the National Institutes of Health, the Agency for Healthcare Research and Quality, the American Heart Association, the CDC, and other funders.

Dr. Guallar was the founding director of the Center for Clinical Epidemiology at the Samsung Medical Center and a lead investigator of the Kangbuk Samsung Cohort Study at the Kangbuk Samsung Hospital since its inception in 2010. Dr. Guallar has published over 500 research papers in peer-reviewed journals. He is also a Deputy Editor for Methods at the Annals of Internal Medicine and a past member and Chair of the Cancer, Heart, and Sleep Study Section at the National Institutes of Health.

Prior to teaching at NYU, Dr. Guallar was a Professor of Epidemiology and Medicine at the Johns Hopkins University Bloomberg School of Public Health and a core faculty member of the Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins. In the Department of Epidemiology, Dr. Guallar was the Director of the Environmental and Occupational Area of Concentration and the Co-Director of the PhD Program. Dr. Guallar was also an adjunct Professor at the Department of Clinical Research Design and Evaluation of the Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, in Seoul, Korea.

Education

Diploma of English, Spanish Official School of Languages at Zaragoza (Escuela Oficial de Idiomas de Zaragoza), Zaragoza, Spain

MD, University of Zaragoza, Zaragoza, Spain

MPH, University of Minnesota, Minneapolis, MN

DrPH, Harvard University, Boston, MA

Honors and awards

Six Honor Calls in the MD Program, University of Zaragoza School of Medicine (1981)

Fellow of Spain’s Program of Training of Graduate Research of the Ministry of Education and Science, University of Zaragoza (1988)

Fulbright Scholar, sponsored by Spain’s Ministry of Health and Consumer Affairs (1989)

Faculty Innovation Award, Johns Hopkins University Bloomberg School of Public Health (2001)

Scientist Development Award, American Heart Association (2002)

Fellow of the American Heart Association, Council on Epidemiology and Prevention (2013)

Advising, Mentoring, and Teaching Recognition Award 2014 – 2015, Johns Hopkins University Bloomberg School of Public Health (2015)

High Impact Research Icon, University of Malaya (2015)

Publications

Publications

Letter : association of circulating bile acid concentrations and non-alcoholic fatty liver disease—authors’ reply

Rivera-Andrade, A., Petrick, J. L., Alvarez, C. S., Graubard, B. I., Florio, A. A., Kroker-Lobos, M. F., Parisi, D., Freedman, N. D., Lazo, M., Guallar, E., Groopman, J. D., Ramirez-Zea, M., & McGlynn, K. A. (n.d.).

Publication year

2022

Journal title

Alimentary Pharmacology and Therapeutics

Volume

56

Issue

2

Page(s)

374-375

10.1111/apt.17059

Abstract

Abstract

~

Letter : is it appropriate to use a fatty liver index >60 as an alternative criterion for non-alcoholic fatty liver disease? Authors’ reply

Rivera-Andrade, A., Petrick, J. L., Alvarez, C. S., Graubard, B. I., Florio, A. A., Kroker-Lobos, M. F., Parisi, D., Freedman, N. D., Lazo, M., Guallar, E., Groopman, J. D., Ramirez-Zea, M., & McGlynn, K. A. (n.d.).

Publication year

2022

Journal title

Alimentary Pharmacology and Therapeutics

Volume

56

Issue

2

Page(s)

378-379

10.1111/apt.17060

Abstract

Abstract

~

Letter and reply : Reply

Spector, J. T., Navas-Acien, A., Fadrowski, J., Guallar, E., Jaar, B., & Weaver, V. (n.d.).

Publication year

2013

Journal title

Nephrology Dialysis Transplantation

Volume

28

Issue

8

Page(s)

e8-e9

10.1093/ndt/gfs083

Abstract

Abstract

~

Letter to the editor

Tellez-Plaza, M., Guallar, E., Howard, B. V., & Navas-Acien, A. (n.d.).

Publication year

2013

Journal title

Epidemiology

Volume

24

Issue

5

Page(s)

784-785

10.1097/EDE.0b013e31829f613c

Abstract

Abstract

~

Life's Simple 7 Cardiovascular Health Metrics and Progression of Coronary Artery Calcium in a Low-Risk Population

Kim, S., Chang, Y., Cho, J., Hong, Y. S., Zhao, D., Kang, J., Jung, H. S., Yun, K. E., Guallar, E., Ryu, S., & Shin, H. (n.d.).

Publication year

2019

Journal title

Arteriosclerosis, Thrombosis, and Vascular Biology

Volume

39

Issue

4

Page(s)

826-833

10.1161/ATVBAHA.118.311821

Abstract

Abstract

Objective- We examined the association of cardiovascular health (CVH) metrics with the development and progression of coronary artery calcium (CAC) among apparently healthy adults. Approach and Results- This cohort study included 65 494 men and women 30 years of age and older free of cardiovascular disease at baseline who underwent a comprehensive exam including CAC scoring. CVH metrics were defined according to the American Heart Association Life's Simple 7 metrics based on smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose. CVH scores range from 0 (all metrics considered unhealthy) to 7 (all metrics considered healthy). Participants were followed-up for a maximum of 6.6 years. Compared with participants with ideal CVH scores 0-1, the multivariable-adjusted difference in the change in geometric means of CAC scores over 5 years of follow-up were -0.40 (-0.62 to -0.19), -0.83 (-1.03 to -0.63), -1.06 (-1.25 to -0.86), -1.22 (-1.42 to -1.03), and -1.05 (-1.42 to -0.69) in participants with ideal CVH scores 2, 3, 4, 5, and 6-7, respectively. The inverse association between CVH scores and progression of CAC was observed both in participants with no CAC and in those with CAC detectable at baseline. Conclusions- A higher ideal CVH metrics score was strongly associated with a lower prevalence of CAC and with lower progression of CAC in males and females in a large cohort of healthy adults. Our findings suggest that maintaining a healthy life habits could help reduce the development and progression of subclinical atherosclerosis and ultimately prevent clinically cardiovascular event.

Long-Term Air Pollution Exposure and Mitochondrial DNA Copy Number : An Analysis of UK Biobank Data

Hong, Y. S., Battle, S. L., Puiu, D., Shi, W., Pankratz, N., Zhao, D., Arking, D. E., & Guallar, E. (n.d.).

Publication year

2023

Journal title

Environmental health perspectives

Volume

131

Issue

5

10.1289/EHP11946

Abstract

Abstract

~

Long-term particulate matter exposure and incidence of arrhythmias : A cohort study

Zhang, Z., Kang, J., Hong, Y. S., Chang, Y., Ryu, S., Park, J., Cho, J., Guallar, E., Shin, H. C., & Zhao, D. (n.d.).

Publication year

2020

Journal title

Journal of the American Heart Association

Volume

9

Issue

22

10.1161/JAHA.120.016885

Abstract

Abstract

BACKGROUND: Studies have shown that short-term exposure to air pollution is associated with cardiac arrhythmia hospitalization and mortality. However, the relationship between long-term particulate matter air pollution and arrhythmias is still unclear. We evaluate the prospective association between particulate matter (PM) air pollution and the risk of incident arrhythmia and its subtypes. METHODS AND RESULTS: Participants were drawn from a prospective cohort study of 178 780 men and women who attended regular health screening exams in Seoul and Suwon, South Korea, from 2002 to 2016. Exposure to PM with an aerodynamic diameter of ≤10 and ≤2.5 μm (PM10 and PM2.5, respectively) was estimated using a land-use regression model. The associations between long-term PM air pollution and arrhythmia were examined using pooled logistic regression models with time-varying exposure and covariables. In the fully adjusted model, the odds ratios (ORs) for any arrhythmia associated with a 10 μg/m3 increase in 12-, 36-, and 60-month PM10 exposure were 1.15 (1.09, 1.21), 1.12 (1.06, 1.18), and 1.14 (1.08, 1.20), respectively. The ORs with a 10 μg/m3 increase in 12-and 36-month PM2.5 exposure were 1.27 (1.15, 1.40) and 1.10 (0.99, 1.23). PM10 was associated with increased risk of incident bradycardia and premature atrial contraction. PM2.5 was associated with increased risk of incident bradycardia and right bundle-branch block. CONCLUSIONS: In this large cohort study, long-term exposure to outdoor PM air pollution was associated with increased risk of arrhythmia. Our findings indicate that PM air pollution may be a contributor to cardiac arrhythmia in the general population.

Long-term particulate matter exposure and onset of depression in middle-aged men and women

Zhang, Z., Zhao, D., Hong, Y. S., Chang, Y., Ryu, S., Kang, D., Monteiro, J., Shin, H. C., Guallar, E., & Cho, J. (n.d.).

Publication year

2019

Journal title

Environmental health perspectives

Volume

127

Issue

7

10.1289/EHP4094

Abstract

Abstract

BACKGROUND: Long-term exposure to particulate matter (PM) air pollution is associated with all-cause mortality and adverse cognitive outcomes, but the association with developing depression remains inconsistent. OBJECTIVE: Our goal was to evaluate the prospective association between PM air pollution and developing depression assessed using the Center for Epidemiological Studies Depression (CES-D) scale. METHODS: Subjects were drawn from a prospective cohort study of 123,045 men and women free of depressive symptoms at baseline who attended regular screening exams in Seoul and Suwon, South Korea, from 2011 to 2015. Exposure to PM with an aerodynamic diameter of

Long-Term β-blocker therapy and clinical outcomes after acute myocardial infarction in patients without heart failure : Nationwide cohort study

Kim, J., Kang, D., Park, H., Kang, M., Park, T. K., Lee, J. M., Yang, J. H., Song, Y. B., Choi, J. H., Choi, S. H., Gwon, H. C., Guallar, E., Cho, J., & Hahn, J. Y. (n.d.).

Publication year

2020

Journal title

European Heart Journal

Volume

41

Issue

37

Page(s)

3521-3529

10.1093/eurheartj/ehaa376

Abstract

Abstract

Aims: To investigate the association between long-Term β-blocker therapy and clinical outcomes in patients without heart failure (HF) after acute myocardial infarction (AMI). Method and results: Between 2010 and 2015, a total of 28 970 patients who underwent coronary revascularization for AMI with β-blocker prescription at hospital discharge and were event-free from death, recurrent myocardial infarction (MI), or HF for 1 year were enrolled from Korean nationwide medical insurance data. The primary outcome was all-cause death. The secondary outcomes were recurrent MI, hospitalization for new HF, and a composite of all-cause death, recurrent MI, or hospitalization for new HF. Outcomes were compared between β-blocker therapy for ≥1 year (N = 22 707) and β-blocker therapy for

Low anti-Müllerian hormone levels are associated with an increased risk of incident early-onset vasomotor symptoms among premenopausal women

NamGoung, S. J., Chang, Y., Kim, Y., Kim, H., Cho, I. Y., Kwon, R., Lim, G. Y., Choi, H. R., Kang, J., Kim, K. H., Hong, Y. S., Zhao, D., Park, H. Y., Cho, J., Guallar, E., Kwon, M. J., & Ryu, S. (n.d.).

Publication year

2022

Journal title

Scientific reports

Volume

12

Issue

1

10.1038/s41598-022-16182-7

Abstract

Abstract

The role of anti-Müllerian hormone (AMH) levels in incident vasomotor symptoms (VMS) is largely unknown. This study aimed to investigate the relationship between AMH levels and the development of early-onset VMS among premenopausal women. Our cohort study comprised 2041 premenopausal women aged 42–52 years free of VMS at baseline whose AMH levels were measured. VMS, including hot flushes and night sweats, were assessed using the Korean version of the Menopause-specific Quality of Life questionnaire. Early-onset VMS was defined as the occurrence of VMS prior to menopause. Parametric proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% CI. During a median follow-up of 4.4 years, 708 premenopausal women developed early-onset VMS (incidence rate, 8.0 per 100 person-years). Lower AMH levels were statistically significantly associated with an increased risk of early-onset VMS. After adjusting for age and other confounders, multivariable-adjusted HRs (95% CI) for incident VMS comparing AMH quintiles 4–1 to the highest quintile were 1.02 (0.78–1.33), 1.37 (1.06–1.76), 1.36 (1.04–1.76), and 2.38 (1.84–3.08), respectively (P for trend < 0.001). Our results support an independent role of serum AMH levels in predicting incident early-onset VMS among premenopausal women in the late reproductive stage.

Low rates of both lipid-lowering therapy use and achievement of low-density lipoprotein cholesterol targets in individuals at high-risk for cardiovascular disease across Europe

Halcox, J. P., Tubach, F., Lopez-Garcia, E., De Backer, G., Borghi, C., Dallongeville, J., Guallar, E., Medina, J., Perk, J., Sazova, O., Sweet, S., Roy, C., Banegas, J. R., & Rodriguez-Artalejo, F. (n.d.).

Publication year

2015

Journal title

PloS one

Volume

10

Issue

2

10.1371/journal.pone.0115270

Abstract

Abstract

Aims: To analyse the treatment and control of dyslipidaemia in patients at high and very high cardiovascular risk being treated for the primary prevention of cardiovascular disease (CVD) in Europe. Methods and Results: Data were assessed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336), which included a randomly sampled population of primary CVD prevention patients from 12 European countries (n = 7641). Patients' 10-year risk of CVD-related mortality was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm, identifying 5019 patients at high cardiovascular risk (SCORE ≥5% and/or receiving lipid-lowering therapy), and 2970 patients at very high cardiovascular risk (SCORE ≥10% or with diabetes mellitus). Among high-risk individuals, 65.3% were receiving lipid-lowering therapy, and 61.3% of treated patients had uncontrolled low-density lipoprotein cholesterol (LDL-C) levels (≥2.5 mmol/L). For very-high-risk patients (uncontrolled LDL-C levels defined as ≥1.8 mmol/L) these figures were 49.5% and 82.9%, respectively. Excess 10-year risk of CVD-related mortality (according to SCORE) attributable to lack of control of dyslipidaemia was estimated to be 0.72%and 1.61% among high-risk and very-high-risk patients, respectively. Among high-risk individuals with uncontrolled LDL-C levels, only 8.7% were receiving a high-intensity statin (atorvastatin ≥40 mg/day or rosuvastatin ≥20 mg/day). Among veryhighrisk patients, this figure was 8.4%. Conclusions: There is a considerable opportunity for improvement in rates of lipid-lowering therapy use and achievement of lipid-level targets in high-risk and very-high-risk patients being treated for primary CVD prevention in Europe.

Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men : The Multicenter AIDS Cohort Study (MACS)

Tibuakuu, M., Zhao, D., Saxena, A., Brown, T. T., Jacobson, L. P., Palella, F. J., Witt, M. D., Koletar, S. L., Margolick, J. B., Guallar, E., Korada, S. K., Budoff, M. J., Post, W. S., & Michos, E. D. (n.d.).

Publication year

2018

Journal title

Journal of Cardiovascular Computed Tomography

Volume

12

Issue

2

Page(s)

131-138

10.1016/j.jcct.2018.01.007

Abstract

Abstract

Background: HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown. Methods: We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010–2013. Of these, 379 also underwent coronary CT angiography for non-calcified coronary plaque (NCP) and obstructive coronary stenosis ≥50%. Multivariable-adjusted Poisson regression was used to estimate prevalence risk ratios of associations between low muscle mass (

Low toenail chromium concentration and increased risk of nonfatal myocardial infarction

Guallar, E., Jiménez, F. J., Van 't Veer, P., Bode, P., Riemersma, R. A., Gómez-Aracena, J., Kark, J. D., Arab, L., Kok, F. J., & Martín-Moreno, J. M. (n.d.).

Publication year

2005

Journal title

American Journal of Epidemiology

Volume

162

Issue

2

Page(s)

157-164

10.1093/aje/kwi180

Abstract

Abstract

Chromium intake may increase insulin sensitivity, glucose tolerance, and the ratio of high density lipoprotein cholesterol to low density lipoprotein cholesterol. However, the epidemiologic evidence on the association between chromium and cardiovascular disease is very limited. To determine whether low toenail chromium concentrations were associated with risk of nonfatal myocardial infarction, the authors conducted an incident, population-based, case-control study in eight European countries and Israel in 1991-1992. Cases (n = 684) were men with a first diagnosis of myocardial infarction recruited from the coronary units of participating hospitals. Controls (n = 724) were men selected randomly from population registers (five study centers) or through other sources, such as hospitalized patients (three centers), general practitioners' practices (one center), or relatives or friends of cases (one center). Toenail chromium concentration was assessed by neutron activation analysis. Average toenail chromium concentrations were 1.10 μg/g in cases (95% confidence interval: 1.01, 1.18) and 1.30 μg/g in controls (95% CI: 1.21, 1.40). Multivariate odds ratios for quintiles 2-5 were 0.82 (95% CI: 0.52, 1.31), 0.68 (95% CI: 0.43, 1.08), 0.60 (95% CI: 0.37, 0.97), and 0.59 (95% CI: 0.37, 0.95). Toenail chromium concentration was inversely associated with the risk of a first myocardial infarction in men. These results add to an increasing body of evidence that points to the importance of chromium for cardiovascular health.

Low-moderate urine arsenic and biomarkers of thrombosis and inflammation in the Strong Heart Study

Moon, K. A., Navas-Acien, A., Grau-Pérez, M., Francesconi, K. A., Goessler, W., Guallar, E., Umans, J. G., Best, L. G., & Newman, J. D. (n.d.).

Publication year

2017

Journal title

PloS one

Volume

12

Issue

8

10.1371/journal.pone.0182435

Abstract

Abstract

The underlying pathology of arsenic-related cardiovascular disease (CVD) is unknown. Few studies have evaluated pathways through thrombosis and inflammation for arsenic-related CVD, especially at low-moderate arsenic exposure levels (

Lower-normal TSH is associated with better metabolic risk factors : A cross-sectional study on Spanish men

Guallar, E., Laclaustra, M., Hurtado-Roca, Y., Sendin, M., Leon, M., Ledesma, M., Andres, E., Fernandez-Ortiz, A., Guallar, E., Ordovas, J. M., & Casasnovas, J. A. (n.d.).

Publication year

2015

Journal title

Nutrition, Metabolism and Cardiovascular Diseases

Volume

25

Issue

12

Page(s)

1095-1103

10.1016/j.numecd.2015.09.007

Abstract

Abstract

Background and aims: Subclinical thyroid conditions, defined by normal thyroxin (T4) but abnormal thyroid-stimulating hormone (TSH) levels, may be associated with cardiovascular and metabolic risk. More recently, TSH levels within the normal range have been suggested to be associated with metabolic syndrome and cardiovascular risk. This work studies the linearity of the relationship between metabolic syndrome and TSH across the euthyroid range. Methods and results: We studied 3533 male participants of the Aragon Workers' Health Study (AWHS) with normal TSH and free T4 levels, across quintiles of these variables, after adjusting for age, alcohol intake, and smoking. Compared with the lowest TSH quintile, the odds ratios for metabolic syndrome at the higher quintiles, which indicate lower thyroid function, were 1.34 (1.04, 1.73), 1.56 (1.21, 2.01), 1.57 (1.22, 2.03), and 1.71 (1.32, 2.21). The lowest free T4 quintile also showed an odds ratio of 1.49 (1.16, 1.90) with respect to the highest quintile. In addition, spline models showed departures from linearity: the risk of metabolic syndrome mostly increases at TSH values below the median (sample half-closest to subclinical hyperthyroidism). Interestingly, glucose also increases with TSH primarily below the median TSH, diastolic blood pressure shows similar changes across the entire TSH range, whereas body mass index, triglycerides, and high-density lipoprotein (HDL)-cholesterol change only at the highest normal TSH values, which are associated with lower free T4 concentration. Conclusions: TSH and free T4 within the normal range are associated with the metabolic syndrome. The sample half-below the TSH median (with probably higher functional thyroid status) exhibited better metabolic and cardiovascular profiles.

Mapping progress in reducing cardiovascular risk with kidney disease : Sudden cardiac death

Shafi, T., & Guallar, E. (n.d.).

Publication year

2018

Journal title

Clinical Journal of the American Society of Nephrology

Volume

13

Issue

9

Page(s)

1429-1431

10.2215/CJN.02760218

Abstract

Abstract

~

Measuring arsenic exposure, metabolism, and biological effects : The role of urine proteomics

Navas-Acien, A., & Guallar, E. (n.d.).

Publication year

2008

Journal title

Toxicological Sciences

Volume

106

Issue

1

Page(s)

1-4

10.1093/toxsci/kfn172

Abstract

Abstract

~

Medical Masks Versus N95 Respirators for Preventing COVID-19 Among Health Care Workers_04

Laine, C., Wee, C. C., Chang, S., Cotton, D., Chopra, V., Williams, S. V., Yu-Xiao, Y., Guallar, E., & Ross, E. A. (n.d.).

Publication year

2023

Journal title

Annals of internal medicine

Volume

176

Issue

7

10.7326/L23-0074

Abstract

Abstract

~

Menopausal stage transitions and their associations with overall and individual sleep quality in middle-aged Korean women

Jang, Y., Chang, Y., Park, J., Kim, C., Jeon, S. W., Kang, J., Kwon, R., Lim, G. y., Kim, K. H., Kim, H., Hong, Y. S., Park, J., Zhao, D., Cho, J., Guallar, E., Park, H. Y., & Ryu, S. (n.d.).

Publication year

2025

Journal title

Journal of Affective Disorders

Volume

368

Page(s)

82-89

10.1016/j.jad.2024.09.050

Abstract

Abstract

Background: Understanding the association between the menopausal transition and declining sleep quality can guide optimal timing for preventive interventions in transitioning women. However, studies lack representation of Asian women and sufficient data on the progression of menopausal stages and sleep quality changes over time in this population. Methods: This study included 3305 women in the pre-menopause stage at baseline. The sleep quality and its components were assessed using the Pittsburgh Sleep Quality Index (PSQI). Menopausal stages were classified as pre-menopause, early transition, late transition, and post-menopause according to the Stages of Reproductive Aging Workshop+10 (STRAW+10) criteria. We estimated the longitudinal association between menopausal stage changes over time and the PSQI score, and examined the effect of being overweight. Results: The trends in the PSQI scores and its components according to the menopausal stage changes over time showed that with the exception of sleep duration and habitual sleep efficiency, an overall decline was noted in sleep health during late transition and post-menopause compared to pre-menopause. These associations were independent of time-variant annual chronological aging, which was not significantly associated with sleep deterioration. Additionally, although the associations between menopausal stages and sleep quality did not significantly differ by adiposity level, the overweight group exhibited worse PSQI scores and components than did the non-overweight group. Limitation: Sleep quality and menopausal stage were assessed using self-reported questionnaires without objective measures. Conclusion: Our study underscores the importance of screening for sleep quality deterioration and implementing appropriate measures for women experiencing menopausal transition.

Menopausal stages and overactive bladder symptoms in middle-aged women : A cross-sectional study

Park, J., Chang, Y., Kim, J. H., Choi, H. R., Kwon, R., Lim, G. Y., Ahn, J., Kim, K. H., Kim, H., Hong, Y. S., Zhao, D., Cho, J., Guallar, E., Park, H. Y., & Ryu, S. (n.d.).

Publication year

2024

Journal title

BJOG: An International Journal of Obstetrics and Gynaecology

10.1111/1471-0528.17912

Abstract

Abstract

Objective: To examine the prevalence of overactive bladder (OAB) according to menopausal stages in middle-aged women. Design: Cross-sectional study. Setting: Total Healthcare Center in South Korea. Population: Middle-aged Korean women (n=3469, mean age, 49.5 ± 2.9 years). Methods: Menopausal stages were defined according to the Stages of Reproductive Aging Workshop +10 criteria, and menopausal symptoms were assessed using the Korean version of Menopause-Specific Quality of Life (MENQOL). Logistic regression models were used to estimate prevalence ratios with 95% confidence intervals for OAB according to menopausal stage and to assess the associations with menopausal symptoms. Main Outcome Measures: OAB symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS). Results: The prevalence of OAB increased with menopausal stage; however, the multivariable-adjusted prevalence ratios for women in menopausal transition and postmenopausal stage were insignificant (ptrend = 0.160) compared to those for premenopausal women. Among individual OAB symptoms, the multivariable-adjusted prevalence ratios for nocturia increased with menopausal stage in a dose–response manner (ptrend = 0.005 for 1 time/day; ptrend < 0.001 for ≥2 times/day). The association between menopausal stages and nocturia occurring ≥2 times/day was evident in women without OAB and with relatively high MENQOL scores, vasomotor symptoms and difficulty sleeping. Conclusions: The prevalence of OAB, particularly nocturia, increased with menopausal stage, and the association was obvious in women with other menopausal symptoms. This finding underscores the importance of addressing nocturia as a potential menopausal symptom in middle-aged women. Further studies are required to understand the mechanisms linking OAB with menopausal symptoms in middle-aged women.

Mens sana in corpore sano

Podewils, L. J., & Guallar, E. (n.d.).

Publication year

2006

Journal title

Annals of internal medicine

Volume

144

Issue

2

Page(s)

135-136

10.7326/0003-4819-144-2-200601170-00011

Abstract

Abstract

~

Mercury and the risk of myocardial infarction [3] (multiple letters)

Plante, M., Babo, S., Mutter, J., Naumann, J., Buettner, C., Guallar, E., Riemersma, R. A., Kok, F. J., Yoshizawa, K., Rimm, E. B., Willett, W. C., Bolger, P. M., & Schwetz, B. (n.d.).

Publication year

2003

Journal title

New England Journal of Medicine

Volume

348

Issue

21

Page(s)

2151-2154

10.1056/NEJM200305223482119

Abstract

Abstract

~

Mercury Exposure and Heart Rate Variability : a Systematic Review

Gribble, M. O., Cheng, A., Berger, R. D., Rosman, L., & Guallar, E. (n.d.).

Publication year

2015

Journal title

Current environmental health reports

Volume

2

Issue

3

Page(s)

304-314

10.1007/s40572-015-0053-0

Abstract

Abstract

Background: Mercury affects the nervous system and has been implicated in altering heart rhythm and function. We sought to better define its role in modulating heart rate variability, a well-known marker of cardiac autonomic function. Design: This is a systematic review study. Methods: We searched PubMed, Embase, TOXLINE, and DART databases without language restriction. We report findings as a qualitative systematic review because heterogeneity in study design and assessment of exposures and outcomes across studies, as well as other methodological limitations of the literature, precluded a quantitative meta-analysis. Results: We identified 12 studies of mercury exposure and heart rate variability in human populations (ten studies involving primarily environmental methylmercury exposure and two studies involving occupational exposure to inorganic mercury) conducted in Japan, the Faroe Islands, Canada, Korea, French Polynesia, Finland, and Egypt. The association of prenatal mercury exposure with lower high-frequency band scores (thought to reflect parasympathetic activity) in several studies, in particular the inverse association of cord blood mercury levels with the coefficient of variation of the R-R intervals and with low-frequency and high-frequency bands at 14 years of age in the Faroe Islands birth cohort study, suggests that early mercury exposure could have a long-lasting effect on cardiac parasympathetic activity. Studies with later environmental exposures to mercury in children or in adults were heterogeneous and did not show consistent associations. Conclusions: The evidence was too limited to draw firm causal inferences. Additional research is needed to elucidate the effects of mercury on cardiac autonomic function, particularly as early-life exposures might have lasting impacts on cardiac parasympathetic function.

Mercury exposure in young adulthood and incidence of diabetes later in life : The CARDIA trace element study

He, K., Xun, P., Liu, K., Morris, S., Reis, J., & Guallar, E. (n.d.).

Publication year

2013

Journal title

Diabetes Care

Volume

36

Issue

6

Page(s)

1584-1589

10.2337/dc12-1842

Abstract

Abstract

OBJECTIVE - Laboratory studies suggest that exposure to methylmercury at a level similar to those found in fish may induce pancreatic islet β-cell dysfunction. Few, if any, human studies have examined the association between mercury exposure and diabetes incidence. We examined whether toenail mercury levels are associated with incidence of diabetes in a large prospective cohort. RESEACH DESIGN AND METHODS - A prospective cohort of 3,875 American young adults, aged 20-32 years, free of diabetes in 1987 (baseline), were enrolled and followed six times until 2005. Baseline toenail mercury levels were measured with instrumental neutron-activation analysis. Incident diabetes was identified by plasma glucose levels, oral glucose tolerance tests, hemoglobin A1C levels, and/or antidiabetes medications. RESULTS - A total of 288 incident cases of diabetes occurred over 18 years of follow-up. In multivariate analyses adjusted for age, sex, ethnicity, study center, education, smoking status, alcohol consumption, physical activity, family history of diabetes, intakes of long-chain n-3 fatty acids and magnesium, and toenail selenium, toenail mercury levels were positively associated with the incidence of diabetes. The hazard ratio (95% CI) of incident diabetes compared the highest to the lowest quintiles of mercury exposure was 1.65 (1.07 -2.56; P for trend = 0.02). Higher mercury exposure at baseline was also significantly associated with decreased homeostasis model assessment of β-cell function index (P for trend < 0.01). CONCLUSIONS - Our results are consistent with findings from laboratory studies and provide longitudinal human data suggesting that people with high mercury exposure in young adulthood may have elevated risk of diabetes later in life.

Mercury, fish oils, and the risk of myocardial infarction

Guallar, E., Sanz-Gallardo, M. I., Van'T Veer, P., Bode, P., Aro, A., Gómez-Aracena, J., Kark, J. D., Riemersma, R. A., Martín-Moreno, J. M., & Kok, F. J. (n.d.).

Publication year

2002

Journal title

New England Journal of Medicine

Volume

347

Issue

22

Page(s)

1747-1754

10.1056/NEJMoa020157

Abstract

Abstract

Background: It has been suggested that mercury, a highly reactive heavy metal with no known physiologic activity, increases the risk of cardiovascular disease. Because fish intake is a major source of exposure to mercury, the mercury content of fish may counteract the beneficial effects of its n-3 fatty acids. Methods: In a case-control study conducted in eight European countries and Israel, we evaluated the joint. association of mercury levels in toenail clippings and docosahexaenoic acid (C22:6n-3, or DHA) levels in adipose tissue with the risk of a first myocardial infarction among men. The patients were 684 men with a first diagnosis of myocardial infarction. The controls were 724 men selected to be representative of the same populations. Results: The average toenail mercury level in controls was 0.25 μg per gram. After adjustment for the DHA level and coronary risk factors, the mercury levels in the patients were 15 percent higher than those in controls (95 percent confidence interval, 5 to 25 percent). The risk-factor-adjusted odds ratio for myocardial infarction associated with the highest as compared with the lowest quintile of mercury was 2.16 (95 percent confidence interval, 1.09 to 4.29; P for trend = 0.006). After adjustment for the mercury level, the DHA level was inversely associated with the risk of myocardial infarction (odds ratio for the highest vs. the lowest quintile, 0.59; 95 percent confidence interval, 0.30 to 1.19; P for trend = 0.02). Conclusions: The toenail mercury level was directly associated with the risk of myocardial infarction, and the adipose-tissue DHA level was inversely associated with the risk. High mercury content may diminish the cardioprotective effect of fish intake.