Science Inventory

A REVIEW OF EPIDEMIOOGICAL STUDIES ON DRINKING WATER HARDNESS AND CARDIOVASCULAR DISEASES

Citation:

MONARCA, S., F. DONATO, R. L. CALDERON, AND G. F. CRAUN. A REVIEW OF EPIDEMIOOGICAL STUDIES ON DRINKING WATER HARDNESS AND CARDIOVASCULAR DISEASES. The Journal of Cardiovascular Prevention & Rehabilitation. Lippincott Williams & Wilkins, Philadelphia, PA, 13(4):495-506, (2006).

Impact/Purpose:

To review epidemiological studies published on drinking water hardness, calcium and magnesium levels, and cardiovascular disease.

Description:

Major risk factors do not entirely explain the worldwide variability of morbidity and mortality due to

cardiovascular disease. Several environmental factors, including the hardness of drinking water may

affect cardiovascular disease risks. We conducted a qualitative review of the epidemiological studies

published on drinking water hardness, calcium and magnesium levels, and cardiovascular disease.

Many of the more than 50 ecological studies published from 1957 to 1978 reported an inverse or

protective association between hardness and cardiovascular disease mortality, but the results are not

consistent. After 1978, a total of 18 ecological, 7 case-control and 2 cohort studies were published.

Although the more recent studies provide little or no evidence for an association between drinking

water hardness or calcium levels and cardiovascular disease, most of the studies found a reduction in

cardiovascular disease risk with increasing magnesium levels in drinking water. Additional evidence

from toxicological, dietary, and other epidemiological studies supports the hypothesis that a low intake

of magnesium is a condition that increases the risk of dying from, and possibly developing,

cardiovascular disease or stroke. However, the association is likely to be weak compared to the major

risk factors for cardiovascular disease. There is some evidence available about the benefits of

magnesium intake, especially in drinking water, and cardiovascular disease. Thus, not removing

magnesium from or, in certain situations, increasing the magnesium intake from drinking water may be

beneficial, especially for populations with an insufficient dietary intake of the mineral.

Record Details:

Record Type: DOCUMENT (JOURNAL/PEER REVIEWED JOURNAL)
Product Published Date: 08/01/2006
Record Last Revised: 08/13/2008
OMB Category: Other
Record ID: 117496

Organization:

U.S. ENVIRONMENTAL PROTECTION AGENCY

OFFICE OF RESEARCH AND DEVELOPMENT

NATIONAL HEALTH AND ENVIRONMENTAL EFFECTS RESEARCH LABORATORY

HUMAN STUDIES DIVISION

IMMEDIATE OFFICE