A systematic review of analytical observational studies investigating the association between cardiovascular disease and drinking water hardness

Catling, Louise A., Abubakar, Ibrahim, Lake, Iain R. ORCID: https://orcid.org/0000-0003-4407-5357, Swift, Louise and Hunter, Paul R. ORCID: https://orcid.org/0000-0002-5608-6144 (2008) A systematic review of analytical observational studies investigating the association between cardiovascular disease and drinking water hardness. Journal of Water and Health, 6 (4). pp. 433-442. ISSN 1996-7829

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Abstract

The aim of this study is to systematically review and critically assess analytical observational epidemiology studies investigating the association between levels of drinking water hardness and cardiovascular disease. We searched electronic databases and used standardised forms to extract data and assess study quality. Of 2,906 papers identified, 14 met the inclusion criteria (nine case control and five cohort studies). Of the nine case control studies, seven examined both drinking water magnesium and calcium and risk of death from cardiovascular disease. A pooled odds ratio showed a statistically significant inverse association between magnesium and cardiovascular mortality (OR 0.75 (95%CI 0.68, 0.82), p < 0.001). Only two studies reported a statistically significant effect for calcium. Substantial heterogeneity between studies made calculation of a summary estimate for drinking water calcium inappropriate. Of three cohort studies reviewed, two were of good quality. A weak suggestion that soft water was harmful in females and possibly associated with a slightly greater risk of sudden death was reported, but there was no association between water hardness and mortality from stroke or cardiovascular disease. This study found significant evidence of an inverse association between magnesium levels in drinking water and cardiovascular mortality following a meta-analysis of case control studies. Evidence for calcium remains unclear.

Item Type: Article
Uncontrolled Keywords: sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Science > School of Environmental Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
University of East Anglia Research Groups/Centres > Theme - ClimateUEA
UEA Research Groups: Faculty of Science > Research Groups > Environmental Social Sciences
University of East Anglia Schools > Faculty of Science > Tyndall Centre for Climate Change Research
Faculty of Science > Research Centres > Tyndall Centre for Climate Change Research
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Social Sciences > Research Centres > Water Security Research Centre
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: EPrints Services
Date Deposited: 25 Nov 2010 11:09
Last Modified: 19 Oct 2023 00:41
URI: https://ueaeprints.uea.ac.uk/id/eprint/12300
DOI: 10.2166/wh.2008.054

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