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ATHEROSCLEROSIS AND THE GEOCHEMICAL ENVIRONMENT: A CRITICAL REVIEW

This general subject has been receiving increasing scientific attention since 1957, when Kobayashi reported that in Japan there was a “goegraphical relationship between chemical nature of the river water and the death rate from apoplexy”.’ This original epidemiologic observation has been followed up in three general directions to investigate this apparent relationship between water composition and cardiovascular disease: ( 1 ) Epidemiologic studies in several countries have been continued in an attempt to identify more precisely the nature of the association, specific etiologic factors, and the specific type or types of cardiovascular diseases involved. (2) Studies of the distribution of trace elements in tissues and in the serum of patients with atherosclerosis have been carried out. (3) The metabolic role of bulk and trace elements in atherosclerosis has been studied in several experimental animals. We have examined the relationship of water hardness to atherosclerosis by relating data collected in municipal water plants to direct estimates of the aortic and coronary atheroscleroses in populations from several geographical areas.?