Eliseo Guallar
Eliseo Guallar
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Chair and Professor of the Department of Epidemiology
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Professional overview
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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.
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Education
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Diploma of English, Spanish Official School of Languages at Zaragoza (Escuela Oficial de Idiomas de Zaragoza), Zaragoza, SpainMD, University of Zaragoza, Zaragoza, SpainMPH, University of Minnesota, Minneapolis, MNDrPH, Harvard University, Boston, MA
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Honors and awards
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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)
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Publications
Publications
Response by Zhao et al to Letters Regarding Article, "intracranial Atherosclerotic Disease and Incident Dementia : The ARIC Study (Atherosclerosis Risk in Communities)"
AbstractZhao, D., Guallar, E., & Wasserman, B. A. (n.d.).Publication year
2025Journal title
CirculationVolume
151Issue
12Page(s)
e766Abstract~Response to comment on : Kim et al. Prospective study of serum adiponectin and incident metabolic syndrome: The ARIRANG Study. Diabetes Care 2013; 36:1547-1553
AbstractKim, J. Y., Ahn, S. V., & Guallar, E. (n.d.).Publication year
2013Journal title
Diabetes CareVolume
36Issue
9Page(s)
e168Abstract~Response to Letter Regarding Article, "Patterns and Implications of Intracranial Arterial Remodeling in Stroke Patients"
AbstractQiao, Y., Guallar, E., & Wasserman, B. A. (n.d.).Publication year
2016Journal title
StrokeVolume
47Issue
5Page(s)
e87Abstract~Resting heart rate and the incidence and progression of valvular calcium : The Multi-Ethnic Study of Atherosclerosis (MESA)
AbstractAmoakwa, K., Fashanu, O. E., Tibuakuu, M., Zhao, D., Guallar, E., Whelton, S. P., O'Neal, W. T., Post, W. S., Budoff, M. J., & Michos, E. D. (n.d.).Publication year
2018Journal title
AtherosclerosisVolume
273Page(s)
45-52AbstractBackground and aims: Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. Methods: RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. Results: At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03–1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45–2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. Conclusions: Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression.Resting Heart Rate, Short-Term Heart Rate Variability and Incident Atrial Fibrillation (from the Multi-Ethnic Study of Atherosclerosis (MESA))
AbstractHabibi, M., Chahal, H., Greenland, P., Guallar, E., Lima, J. A., Soliman, E. Z., Alonso, A., Heckbert, S. R., & Nazarian, S. (n.d.).Publication year
2019Journal title
American Journal of CardiologyVolume
124Issue
11Page(s)
1684-1689AbstractEvidence suggests an association between autonomical nervous system (ANS) function and atrial fibrillation (AF) development. We sought to examine the association of baseline resting heart rate (RHR) and short-term heart rate variability (HRV) as surrogates of (ANS) with incident AF in individuals without previous cardiovascular disease. A total of 6,261 participants of the Multi-Ethnic Study of Atherosclerosis who were free of AF and diagnosed cardiovascular disease were enrolled. Three standard 10-second, 12-lead electrocardiograms (ECG) were used to measure RHR, the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences in RR intervals (RMSSD). Cox proportional hazards models adjusted for demographics, atrioventricular nodal agents, and known cardiovascular risk factors were used to examine the association of baseline RHR, and log transformed SDNN and RMSDD with incident AF. Over a mean follow-up of 11.3 ± 3.7 years, 754 (12%) participants developed AF. Spline curve analysis revealed a nonlinear association between RHR, HRV, and incident AF. In fully adjusted models higher (but not lower) baseline RHR (RHR >76 beats/min) was associated with incident AF (hazard ratio 1.48 95% confidence interval 1.18 to 1.86). Additionally, lower values of RMSDD and SDNN and higher values of RMSDD were independently associated with incident AF. In conclusion, cardiac ANS dysregulation indicated as higher RHR and lower HRV is associated with incident AF independent of known cardiovascular risk factors.Review : Ambulatory blood pressure monitoring predicts clinical outcomes
AbstractGuallar, E., Appel, L. J., Robinson, K. A., & Guallar, E. (n.d.).Publication year
2003Journal title
Evidence-Based MedicineVolume
8Issue
4Page(s)
120Abstract~Revision de los datos de incidencia de enfermedad invasiva y de meningitis por haemophilus influenzae en ninos menores de 5 anos en Espana
AbstractGuallar, E., Guallar-Castillón, P., Jiménez, F. J., Rubio Terrés, C., & Guallar, E. (n.d.).Publication year
1997Journal title
Anales Espanoles de PediatriaVolume
47Issue
3Page(s)
263-268AbstractObjective: The object of this study was to summarize the available information on the incidence of invasive disease and meningitis caused by Haemophilus influenzae in Spain from 1985 to 1995, evaluating potential geographic differences. Methods: Systematic and exhaustive literature searches of computerized databases, manual review of obtained references, revision of relevant Spanish journals and proceedings of congresses and direct consultation with experts were carried out. Yearly incidence rates were estimated per 100,000 children less than 5 years of age, by year and geographical region. Results: We encountered 16 studies, one coveting the entire Spanish population and the rest limited to Catalonia, the Basque Country, the Valencian Community, Andalucia, Navarra or the Community of Madrid. In 1994, the incidence of invasive H, influenzae disease varied from 8.4 cases per 100,000 children under 5 years of age in Navarra to 26.3 cases per 100,000 children under 5 years of age in the Basque Country. Conclusions: Available data do not permit the nationwide estimation of the incidence rate, although it is possible to appreciate thai important geographic differences exist. It is remarkable the lack of specific information for the majority of Spanish regions, as well as the lack of data to assess temporal trends.Risk factors control for primary prevention of cardiovascular disease in men : Evidence from the Aragon Workers Health Study (AWHS)
AbstractAguilar-Palacio, I., Malo, S., Feja, C., Lallana, M., León-Latre, M., Casasnovas, J. A., Rabanaque, M., & Guallar, E. (n.d.).Publication year
2018Journal title
PloS oneVolume
13Issue
2AbstractBenefits of cardiovascular disease (CVD) risk factors control are well known, but goals achievement remains low. The objective of this study is to evaluate the prevalence of CVD risk factors among men ina worker’s cohort with no previous CVD, to study control variations across time and the factors associated with poor control. To this end, we conducted a cohort reexamination (2010–2014) within the context of the Aragon Workers Health Study (AWHS). Data from working characteristics, analytical values and pharmacological prescription were included in the analysis. Prevalences of risk factor diagnosis and control were calculated, as well as factors associated with poor control. The prevalence of CVD risk factors was high. In 2014dyslipidaemia was the most prevalent (85.2%) followed by Hypertension (HT) (42.0%). People under treatment increased for the period analysed (pRisk factors for hemorrhoidal disease among healthy young and middle-aged Korean adults
AbstractHong, Y. S., Jung, K. U., Rampal, S., Zhao, D., Guallar, E., Ryu, S., Chang, Y., Kim, H. O., Kim, H., Chun, H. K., Sohn, C. I., Shin, H., & Cho, J. (n.d.).Publication year
2022Journal title
Scientific reportsVolume
12Issue
1AbstractHemorrhoidal disease is a highly prevalent anorectal condition causing substantial discomfort, disability, and decreased quality of life. Evidence on preventable risk factors for hemorrhoidal disease is limited. We conducted a cross-sectional study of 194,620 healthy men and women who completed a health screening exam including colonoscopy in 2011–2017. We evaluated potential risk factors of hemorrhoidal disease, including lifestyle factors, medical history, birth history, gastrointestinal symptoms, and anthropometric measurements. The prevalence of hemorrhoidal disease was 16.6%, and it was higher in females than in males (17.2 vs. 16.3%; P < 0.001). Compared to men, the prevalence of hemorrhoidal disease was higher in parous women (adjusted odds ratio [OR] 1.06; 95% confidence interval [CI] 1.02–1.10), and lower in nulliparous women (adjusted OR 0.92; 95% CI 0.86–0.98). In the adjusted analyses, older age, female sex, smoking, overweight, and being hypertensive were independently associated with the presence of hemorrhoidal disease. The prevalence of hemorrhoidal disease was positively associated with body mass index and waist circumference in parous women. The prevalence of hemorrhoidal disease was higher in older age, females, ever-smokers, and hypertensive participants. The association of excess adiposity with the prevalence of hemorrhoidal disease differed by sex and parity.Risk factors, risk prediction, and the apolipoprotein B-apolipoprotein A-I ratio
AbstractBerkwits, M., & Guallar, E. (n.d.).Publication year
2007Journal title
Annals of internal medicineVolume
146Issue
9Page(s)
677-679Abstract~Risk of acute infections in patients with psoriasis : A nationwide population-based cohort study
AbstractKim, B. R., Kang, D., Kang, M., Shim, S., Kang, C. K., Kim, D. W., Guallar, E., Cho, J., & Youn, S. W. (n.d.).Publication year
2020Journal title
Journal of the American Academy of DermatologyVolume
82Issue
3Page(s)
764-766Abstract~Risk of chronic obstructive pulmonary disease in healthy individuals with high C-reactive protein levels by smoking status : A population-based cohort study in Korea
AbstractLim, S. Y., Zhao, D., Guallar, E., Chang, Y., Ryu, S., Cho, J., & Shim, J. Y. (n.d.).Publication year
2019Journal title
International Journal of COPDVolume
14Page(s)
2037-2046AbstractPurpose: Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation. We investigated whether elevated baseline serum C-reactive protein (CRP) levels in healthy individuals are associated with the risk of incident COPD by smoking status. Patients and methods: This was a cohort study of 63,260 adult men and women who were older than 40 years, free of COPD at baseline, and underwent health screening from 2002 to 2016 with at least one follow-up visit through December 2016. We investigated the association between baseline high-sensitivity CRP (hsCRP) levels and incident COPD by smoking status, using flexible parametric proportional hazards models and pooled logistic regression analyses. Results: The multivariable-adjusted hazard ratio (95% confidence interval) comparing participants in the 90th to those in the 10th percentile of hsCRP was 1.19 (1.08, 1.31). The corresponding hazard ratio in never, former, and current smokers were 1.07 (0.89, 1.29), 1.22 (1.05, 1.42), and 1.22 (1.05, 1.41), respectively. The association between hsCRP levels and incident COPD had a similar dose–response pattern in former and current smokers, but not in never smokers. Conclusion: Higher baseline hsCRP is associated with an increased risk to develop COPD in ever smokers but not in never smokers.Risk of Diabetes Associated with Cancer Development - In Reply
AbstractCho, J., Kang, D., Hwangbo, Y., & Guallar, E. (n.d.).Publication year
2019Journal title
JAMA OncologyVolume
5Issue
3Page(s)
E1Abstract~Risk of hepatocellular carcinoma in individuals without traditional risk factors : Development and validation of a novel risk score
AbstractSinn, D. H., Kang, D., Cho, S. J., Paik, S. W., Guallar, E., Cho, J., & Gwak, G. Y. (n.d.).Publication year
2020Journal title
International Journal of EpidemiologyVolume
49Issue
5Page(s)
1562-1571AbstractBackground: Although hepatocellular carcinoma (HCC) occurs mostly in patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection or heavy alcohol use or cirrhosis, some patients develop HCC without these risk factors. Our objective in this study was to develop and validate a new HCC risk score that could stratify HCC risk in patients who develop HCC without known risk factors. Methods: A new HCC risk score was developed using a nationwide, population-based cohort among individuals without chronic HBV infection, chronic HCV infection, heavy alcohol use or cirrhosis (n = 467 206, derivation cohort). The performance of the HCC risk score was validated using an independent Samsung Medical Center Health Promotion Center cohort (n = 91 357, validation cohort). Results: Multivariable Cox regression analysis identified six independent risk factors: age, sex, smoking, diabetes, total cholesterol level and serum alanine aminotransferase level. A 19-point scale for HCC risk score was developed, with 10-year risk of HCC ranging from 0.0% to 6.16% for the lowest and highest risk scores, respectively. The area under the receiver operating characteristics curve values (AUROCs) to predict HCC development were 0.83 [95% confidence interval (CI): 0.77, 0.88)] and 0.92 (95% CI: 0.89, 0.95) at 10 years in the derivation and validation cohorts, respectively. Predicted risk was well correlated with the Kaplan-Meier observed HCC risk. Conclusions: A simple-to-use, novel HCC risk score was developed for predicting HCC development in individuals without alleged risk factors. It can be used to assess the risk of HCC in this population so that decisions about their clinical management, including risk reduction interventions, can be subsequently made.Risk of non-Hodgkin lymphoma in breast cancer survivors : a nationwide cohort study
AbstractKang, D., Yoon, S. E., Shin, D., Lee, J., Hong, Y. S., Lee, S. K., Lee, J. E., Park, Y. H., Ahn, J. S., Guallar, E., Kim, W. S., Lee, J., Kim, S. J., & Cho, J. (n.d.).Publication year
2021Journal title
Blood Cancer JournalVolume
11Issue
12AbstractSeveral studies have suggested that estrogens have a protective function against lymphomagenesis. The treatment of breast cancer is driven by subtype classification, and the assessment of hormone receptor status is important for treatment selection. Thus, we evaluated the association between breast cancer and the incidence of NHL. We conducted a retrospective cohort study using a population-based nationwide registry in South Korea. We selected all women with newly diagnosed breast cancer between January 1st, 2002 and December 31st, 2016 who received curative treatment (N = 84,969) and a 1:10 sample of age-matched non-breast cancer controls (N = 1,057,674). Incident breast cancer (time-varying exposure) was the exposure and development of any type of NHL, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mature T/NK-cell lymphomas, anaplastic large cell lymphoma (ALCL), and unspecified types of NHL, was the outcome. During follow-up, 1564 incident cases of NHL occurred. The fully adjusted Hazard Ratio (HR) for NHL associated with the development of breast cancer was 1.64 (95% CI = 1.34–2.00) after adjusting for body mass index, alcohol intake, physical activity, smoking, income, and comorbidity. The adjusted HR for NHL was much higher in participants who were agedSafety and efficacy of antiplatelet therapy in patients with intermediate coronary artery stenosis and deferred revascularization
AbstractHong, D., Lee, S. H., Heo, J., Shin, D., Cho, J., Guallar, E., Joh, H. S., Kim, H. K., Ha, J., Choi, K. H., Park, T. K., Yang, J. H., Song, Y. B., Hahn, J. Y., Choi, S. H., Gwon, H. C., Kang, D., & Lee, J. M. (n.d.).Publication year
2025Journal title
Revista Espanola de CardiologiaAbstractIntroduction and objectives: This study investigated the safety and efficacy of antiplatelet therapy in patients with intermediate coronary artery stenosis who underwent deferred revascularization due to their fractional flow reserve (FFR). Methods: A nationwide cohort study was conducted using the Korean National Health Insurance Service database. A total of 4657 patients with intermediate coronary artery stenosis who underwent deferred revascularization due to their FFR were identified from 2013 to 2020. FFR was indicated in patients with no prior evidence of myocardial ischemia and intermediate coronary artery stenosis (50%-70%) as determined by quantitative coronary angiography. Patients were classified according to whether antiplatelet therapy was initiated after the index procedure. The primary efficacy outcome was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, unplanned revascularization, and stroke, during a 5-year follow-up period. The primary safety outcome was any gastrointestinal bleeding. Results: After propensity score matching, there were 1634 patients in the antiplatelet therapy group and 1634 in the nonantiplatelet therapy group. The risk of MACCE was similar between the 2 groups (24.8% vs 24.7%; adjusted HR, 0.97; 95%CI, 0.84-1.13; P = 0.745). The risk of gastrointestinal bleeding was higher in the antiplatelet therapy group than in the nonantiplatelet therapy group (2.2% vs 1.2%; aHR, 2.07; 95%CI, 1.08-4.00). These results were similar in subgroup analyses. Conclusions: In patients with intermediate coronary artery stenosis who underwent deferred revascularization due to their FFR, antiplatelet therapy may increase the risk of gastrointestinal bleeding without reducing the risk of future ischemic events.Scalp cooling for preventing persistent chemotherapy-induced alopecia in anthracycline-treated patients : A single-arm trial
AbstractKang, D., Lee, H., Zhao, D., Kim, N., Kim, H., Kim, S., Kim, J. Y., Park, Y. H., Ahn, H. K., Guallar, E., Cho, J., & Ahn, J. S. (n.d.).Publication year
2025Journal title
Journal of the American Academy of DermatologyAbstract~Scalp Cooling in Preventing Persistent Chemotherapy-Induced Alopecia : A Randomized Controlled Trial
AbstractKang, D., Cho, J., Zhao, D., Kim, J., Kim, N., Kim, H., Kim, S., Kim, J. Y., Park, Y. H., Im, Y. H., Guallar, E., & Ahn, J. S. (n.d.).Publication year
2024Journal title
Journal of Clinical OncologyVolume
42Issue
26Page(s)
3115-3122AbstractPURPOSE Current studies of the efficacy of scalp cooling are limited by short-term duration. Therefore, we conducted a randomized controlled trial to evaluate the efficacy of scalp cooling in reducing persistent chemotherapy-induced alopecia (PCIA) 6 months after chemotherapy. METHODS We conducted an open-label randomized controlled trial comparing scalp cooling versus control in newly diagnosed patients with breast cancer stages I-III scheduled to receive neoadjuvant or adjuvant chemotherapy with curative intent between December 2020 and August 2021. Patients were randomly assigned (2:1 ratio) to scalp cooling or usual clinical practice. The primary outcome was PCIA 6 months after chemotherapy. Hair thickness and density were measured using Folliscope 5.0. CIA-related distress was assessed using the CIA distress scale (CADS), with a higher score reflecting higher stress. RESULTS The proportion of patients with PCIA at 6 months was 13.5% (12/89) in the scalp-cooling group and 52.0% (26/50) in the control group. The average difference in the change in hair thickness from baseline between the scalp-cooling and control groups was 9.0 mm in favor of the intervention group. The average difference in the change in hair density between intervention and control at the end of the study was –3.3 hairs/cm2. At 6 months after chemotherapy, the average difference in the change in CADS score between the intervention and control groups was –3.2 points, reflecting reduced CIA-related stress in the intervention group. CONCLUSION Scalp cooling reduced the incidence of PCIA, primarily by increasing hair thickness compared with control. Scalp cooling is helpful in promoting qualitative hair regrowth. Yet, further research is necessary to observe longer-term benefits of scalp cooling.Seafood intake and urine concentrations of total arsenic, dimethylarsinate and arsenobetaine in the U.S. population
AbstractGuallar, E., Navas-Acien, A., Francesconi, K. A., Silbergeld, E. K., & Guallar, E. (n.d.).Publication year
2010Page(s)
319-321Abstract~Seafood intake and urine concentrations of total arsenic, dimethylarsinate and arsenobetaine in the US population
AbstractNavas-Acien, A., Francesconi, K. A., Silbergeld, E. K., & Guallar, E. (n.d.).Publication year
2011Journal title
Environmental ResearchVolume
111Issue
1Page(s)
110-118AbstractBackground: Seafood is the main source of organic arsenic exposure (arsenobetaine, arsenosugars and arsenolipids) in the population. Arsenosugars and arsenolipids are metabolized to several species including dimethylarsinate (DMA). Objective: Evaluate the association of seafood intake with spot urine arsenic concentrations in the 2003-2006 National Health Nutrition and Examination Survey (NHANES). Methods: We studied 4276 participants ≥6 years. Total arsenic was measured using inductively coupled plasma dynamic reaction cell mass spectrometry (ICPMS). Urine DMA and arsenobetaine were measured by high-performance liquid chromatography coupled with ICPMS. Results: Participants reporting seafood in the past 24-h had higher urine concentrations of total arsenic (median 24.5 vs. 7.3 γg/L), DMA (6.0 vs. 3.5 γg/L), arsenobetaine (10.2 vs. 0.9 γg/L) and total arsenic minus arsenobetaine (11.0 vs. 5.5 γg/L). Participants reporting seafood ≥2/wk vs. never during the past year had 2.3 (95% confidence interval 1.9, 2.7), 1.4 (1.2, 1.6), 6.0 (4.6, 7.8) and 1.7 (1.4, 2.0) times higher (p-trendSeeing the Positive in Negative Studies
AbstractGuallar, E., Goodman, S. N., Localio, A. R., Stephens-Shields, A. J., & Laine, C. (n.d.).Publication year
2023Journal title
Annals of internal medicineVolume
176Issue
4Page(s)
561-563Abstract~Selenium and coronary heart disease : A meta-analysis
AbstractFlores-Mateo, G., Navas-Acien, A., Pastor-Barriuso, R., & Guallar, E. (n.d.).Publication year
2006Journal title
American Journal of Clinical NutritionVolume
84Issue
4Page(s)
762-773AbstractBackground: It is hypothesized that low selenium concentrations are associated with an increased risk of cardiovascular disease and that selenium supplements prevent coronary heart disease. Objective: The objective was to perform a meta-analysis on the association of selenium biomarkers with coronary heart disease endpoints in observational studies and on the efficacy of selenium supplements in preventing coronary heart disease endpoints in randomized trials. Design: The MEDLINE and the Cochrane Library databases were searched for studies conducted from 1966 through 2005. Relative risks were pooled by using an inverse-variance weighted random-effects model. Results: Twenty-five observational studies (14 cohort and 11 case-control studies) that measured blood or toenail selenium concentrations and 6 randomized trials that evaluated supplements containing selenium met our inclusion criteria. The pooled relative risk in a comparison of the highest with the lowest selenium concentration categories was 0.85 (95% CI: 0.74, 0.99) in cohort studies and 0.43 (0.29, 0.66) in case-control studies. In observational studies, a 50% increase in selenium concentrations was associated with a 24% (7%, 38%) reduction in coronary heart disease risk. In randomized trials, the pooled relative risk in a comparison of supplements containing selenium with placebo was 0.89 (0.68, 1.17). Conclusions: Selenium concentrations were inversely associated with coronary heart disease risk in observational studies. Because observational studies have provided misleading evidence for other antioxidants, the validity of this association is uncertain. Few randomized trials have addressed the cardiovascular efficacy of selenium supplementation, and their findings are still inconclusive. Evidence from large ongoing trials is needed to establish low selenium concentrations as a cardiovascular disease risk factor. Currently, selenium supplements should not be recommended for cardiovascular disease prevention.Selenium and diabetes : More bad news for supplements
AbstractBleys, J., Navas-Acien, A., & Guallar, E. (n.d.).Publication year
2007Journal title
Annals of internal medicineVolume
147Issue
4Page(s)
271-272Abstract~Selenium and hypertension : Do we need to reconsider selenium supplementation in cancer patients?
AbstractGouni-Berthold, I., Michalke, B., Krone, W., Guallar, E., & Berthold, H. K. (n.d.).Publication year
2013Journal title
Journal of HypertensionVolume
31Issue
5Page(s)
1050-1052Abstract~Selenium intake and cardiovascular risk : What is new?
AbstractNavas-Acien, A., Bleys, J., & Guallar, E. (n.d.).Publication year
2008Journal title
Current Opinion in LipidologyVolume
19Issue
1Page(s)
43-49AbstractPURPOSE OF REVIEW: Selenium is an essential element with a narrow safety margin. Adequate selenium intake is needed to maximize the activity of glutathione peroxidases and other selenoproteins. This review discusses recent experimental and epidemiologic contributions on the role of selenium for the prevention of atherosclerotic cardiovascular disease. RECENT FINDINGS: Few randomized trials have evaluated the efficacy of selenium supplementation on cardiovascular endpoints. Most trials, conducted in selenium-replete populations, found no evidence of cardiovascular protection. A meta-analysis of 13 prospective cohort studies found a moderate inverse relationship between plasma/serum selenium and coronary heart disease. The interpretation of these data is complicated, however, by potential residual confounding and publication bias. In contrast, recent data from trials of selenium-containing supplements and from epidemiologic studies suggest that chronically increased selenium intake in selenium-replete populations can induce diabetes and maybe also hypercholesterolemia. SUMMARY: Current evidence is insufficient to support a protective role for selenium in cardiovascular prevention. Large high-quality randomized controlled trials and observational studies are needed across populations with different levels of selenium intake. Furthermore, subjects living in regions with high selenium intake should be aware that selenium supplements may increase their risk of diabetes and hypercholesterolemia.