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Articles by M Laclaustra
Total Records ( 2 ) for M Laclaustra
  M Laclaustra , A Navas Acien , S Stranges , J. M Ordovas and E. Guallar

Background— Selenium is an antioxidant micronutrient with potential interest for cardiovascular disease prevention. Few studies have evaluated the association between selenium and hypertension, with inconsistent findings. We explored the relationship of serum selenium concentrations with blood pressure and hypertension in a representative sample of the US population.

Methods and Results— We undertook a cross-sectional analysis of 2638 adults ≥40 years old who participated in the 2003 to 2004 National Health and Nutrition Examination Survey. Serum selenium was measured by inductively coupled plasma-dynamic reaction cell-mass spectrometry. Hypertension was defined as blood pressure ≥140/90 mm Hg or current use of antihypertensive medication. Mean serum selenium was 137.1 µg/L. The multivariable adjusted differences (95% CIs) in blood pressure levels comparing the highest (≥150 µg/L) to the lowest (<122 µg/L) quintile of serum selenium were 4.3 (1.3 to 7.4), 1.6 (–0.5 to 3.7), and 2.8 (0.8 to 4.7) mm Hg for systolic, diastolic, and pulse pressure, respectively. The corresponding odds ratio for hypertension was 1.73 (1.18 to 2.53). In spline regression models, blood pressure levels and the prevalence of hypertension increased with increasing selenium concentrations up to 160 µg/L.

Conclusions— High serum selenium concentrations were associated with higher prevalence of hypertension. These findings call for a thorough evaluation of the risks and benefits associated with high selenium status in the United States.

  A. P Carson , C. S Fox , D. K McGuire , E. B Levitan , M Laclaustra , D. M Mann and P. Muntner

Among individuals without diabetes, elevated hemoglobin A1c (HbA1c) has been associated with increased morbidity and mortality, but the literature is sparse regarding the prognostic importance of low HbA1c.

Methods and Results—

National Health and Nutrition Examination Survey III (NHANES III) participants, 20 years and older, were followed up to 12 years (median follow-up, 8.8 years) for all-cause mortality. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between HbA1c levels and all-cause mortality for 14 099 participants without diabetes. There were 1825 deaths during the follow-up period. Participants with a low HbA1c (<4.0%) had the highest levels of mean red blood cell volume, ferritin, and liver enzymes and the lowest levels of mean total cholesterol and diastolic blood pressure compared with their counterparts with HbA1c levels between 4.0% and 6.4%. An HbA1c <4.0% versus 5.0% to 5.4% was associated with an increased risk of all-cause mortality (HR, 3.73; 95% CI, 1.45 to 9.63) after adjustment for age, race-ethnicity, and sex. This association was attenuated but remained statistically significant after further multivariable adjustment for lifestyle, cardiovascular factors, metabolic factors, red blood cell indices, iron storage indices, and liver function indices (HR, 2.90; 95% CI, 1.25 to 6.76).


In this nationally representative cohort, low HbA1c was associated with increased all-cause mortality among US adults without diabetes. Additional research is needed to confirm these results and identify potential mechanisms that may be underlying this association.

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