Domestic water hardness, genetic risk, and distinct phenotypes of cardiovascular disease

Tian, Feng; Yu, Genfeng; Yang, Mengyuan; Sun, Ying; Gui, Zihao; Zhao, Xiaoyu; Wang, Ningjian; Wan, Heng; Peng, Xuetao

doi:10.1186/s12940-025-01166-7

Environmental Health

Table 2 Stratification analysis on the associations of water hardness with incident AF

From: Domestic water hardness, genetic risk, and distinct phenotypes of cardiovascular disease

	CaCO₃ category (using USGS)				P for trend	P for interaction
	≤ 60 mg/L	> 60, ≤ 120 mg/L	> 120, ≤ 180 mg/L	> 180 mg/L	P for trend	P for interaction
Sex ^a
Women	Ref.	1.04 (0.99, 1.09)	0.84 (0.77, 0.91)	1.08 (1.03, 1.13)	0.011	0.222
Men	Ref.	1.04 (1.00, 1.08)	0.82 (0.77, 0.88)	1.02 (0.98, 1.05)	0.813	0.222
Age
< 60	Ref.	1.03 (0.98, 1.09)	0.77 (0.70, 0.85)	0.99 (0.94, 1.04)	0.169	0.017
≥ 60	Ref.	1.04 (1.01, 1.08)	0.85 (0.80, 0.90)	1.06 (1.03, 1.09)	0.015	0.017
Townsend deprivation index
Tertile 1	Ref.	1.07 (1.02, 1.13)	0.83 (0.77, 0.91)	1.07 (1.02, 1.13)	0.08	0.216
Tertile 2	Ref.	1.03 (0.98, 1.08)	0.80 (0.73, 0.87)	1.05 (1.01, 1.10)	0.214	0.216
Tertile 3	Ref.	1.02 (0.97, 1.08)	0.86 (0.78, 0.95)	1.01 (0.97, 1.06)	0.949
Race ^a
White	Ref.	1.04 (1.01, 1.07)	0.83 (0.78, 0.87)	1.04 (1.01, 1.07)	0.167	0.704
others	Ref.	0.91 (0.73, 1.14)	0.95 (0.68, 1.33)	1.07 (0.91, 1.26)	0.214	0.704
Education ^a
University or college degree	Ref.	1.05 (0.99, 1.12)	0.84 (0.76, 0.93)	1.03 (0.98, 1.09)	0.616	0.77
Others	Ref.	1.04 (1.00, 1.07)	0.82 (0.77, 0.87)	1.05 (1.02, 1.09)	0.087	0.77
HbA1c^a
Ideal	Ref.	1.04 (1.00, 1.08)	0.80 (0.75, 0.85)	1.04 (1.00, 1.07)	0.516	0.019
Nonideal	Ref.	1.01 (0.95, 1.07)	0.90 (0.82, 1.00)	1.02 (0.96, 1.07)	0.841	0.019
Smoking ^a
Ideal	Ref.	1.05 (1.01, 1.08)	0.83 (0.78, 0.88)	1.05 (1.02, 1.08)	0.071	0.257
Nonideal	Ref.	0.97 (0.89, 1.06)	0.82 (0.71, 0.96)	1.01 (0.93, 1.09)	0.797	0.257
Cholesterol
Ideal	Ref.	1.05 (1.00, 1.10)	0.82 (0.75, 0.89)	1.04 (0.99, 1.08)	0.546	0.786
Nonideal	Ref.	1.03 (0.99, 1.07)	0.84 (0.78, 0.89)	1.04 (1.01, 1.08)	0.181	0.786
BMI
Ideal	Ref.	1.02 (0.95, 1.08)	0.77 (0.69, 0.86)	0.98 (0.93, 1.04)	0.199	0.253
Nonideal	Ref.	1.05 (1.01, 1.08)	0.84 (0.80, 0.89)	1.05 (1.02, 1.09)	0.046	0.253
Blood pressure ^a
Ideal	Ref.	0.99 (0.87, 1.14)	0.94 (0.76, 1.17)	0.93 (0.82, 1.04)	0.177	0.354
Nonideal	Ref.	1.04 (1.01, 1.07)	0.82 (0.78, 0.87)	1.05 (1.02, 1.08)	0.081	0.354
Physical activity ^a
Ideal	Ref.	1.04 (1.00, 1.09)	0.87 (0.80, 0.94)	1.05 (1.01, 1.09)	0.106	0.535
Nonideal	Ref.	1.02 (0.97, 1.07)	0.79 (0.73, 0.87)	1.02 (0.98, 1.07)	0.947	0.535
Diet ^a
Ideal	Ref.	1.04 (1.00, 1.09)	0.83 (0.77, 0.89)	1.05 (1.01, 1.09)	0.155	0.784
Nonideal	Ref.	1.03 (0.99, 1.08)	0.82 (0.76, 0.89)	1.03 (0.99, 1.08)	0.514	0.784

Model: adjusted for age, sex, ethnicity, education, the Townsend index, smoking status, ideal physical activity, healthy diet score, BMI, total cholesterol, ideal HbA1c, and ideal blood pressure
In the analysis stratified by marked categorical variable, the corresponding variable was excluded from the model
AF, atrial fibrillation; USGS, United States Geological Survey; BMI, body mass index; HbA1c, hemoglobin A1c

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