Abstract
In Finland, where mortality rates of cardiovascular diseases are as a rule among the highest in the world, significant areal differences in these figures are encountered especially between the eastern and western parts of the country. To test the hypothesis that these differences,( the reason of which has long been a subject for a lively debate in Finland), may result from geochemical factors such as variations in the hardness or calcium or magnesium content of well water a correlation analysis was carried out in which the geochemical properties in each of the country's individual administrative districts, or communes (444 in all, excluding Åland) were compared with the percentage of heart diseases among the causes of death from diseases in 1991. The results show a poor or extremely low correlation nation-wide (r ranging from −0.039 to +0.045), indicating a virtual absence of any causal relationship. On the other hand, taken pairwise, the extreme western and eastern provinces, Vaasa andNorthern Karelia, show marked differences both in their geochemical and mortality data, the percentage of deaths caused by cardiovascular diseases being markedly lower in the province of Vaasa, where the hardness and the magnesium content of well water (but not the calcium content) are significantly higher (p < 0.001 and 0.002 respectively). This inverse relationship is in line with the supposition that in addition to other factors, geochemical differences may have an effect on mortality.
Similar content being viewed by others
References
Alalammi, P. (ed.). 1992. Atlas of Finland, pp.123–126. National Board of Survey, Helsinki.
Altura, B.M. and Altura, B.T. 1986. Biochemistry and pathophysiology of congestive heart failure: is there a role for magnesium? Magnesium, 5, 134–143.
Altura, B. M., Altura, T.B. and Gebrewold, A. 1984. Magnesium deficiency and hypertension —correlation between magnesium deficient diets and microcirculatory changes in situ. Science, 223, 1315–1317.
Anderson, T.W. 1977. Water hardness, magnesium and ischemic heart disease. N.S. Med Bull., 56, 58–61.
Anderson, T.W., Neri L.C. and Schreiberg, H.D. 1975. Ischaemic heart disease, water hardness and myocardial magnesium. J. Can. Med. Assoc., 113, 199–203.
Aromaa, A., Maatela, J. and Pyörälä, K. 1977. Prevalence and incidence of hypertension in Finland: The Social Insurance Institution's study on Finnish population groups. Nordic Council for Arctic Medical Research Report, 19, 88–94.
Bloom, S. and Peric-Golia, L. 1989. Geographic variation in the incidence of myocardial calcification associated with acute myocardial infarction. Human Pathology, 20, 726–731.
Comstock, G.W. 1980. The epidemiological perspective: water hardness and cardiovascular disease. J. Environ. Pathol. Toxicol., 3, 9–25.
Crawford, M.D., Garner, M.S. and Morris, J.N. 1971. Changes in water hardness and local death rates. Lancet, 2, 327–329.
Crawford, T. and Crawford, M.D. 1967. Prevalence and pathological changes of ischaemic heart disease in a hard-water and in a soft-water area. Lancet, 1, 229–232.
de Faire, U., Arvidsson, A. and Bolander, A.-M. 1977. Mortality from ischaemic heart disease among Finnish immigrants in Sweden. Nordic Council for Arctic Medical Research Report, 19, 29–31.
Dixon, W.J. (ed.). 1981. BMDP Statistical Software 1981. University of California Press, Berkeley.
Dzik, A.J. 1989. Cerebrovascular disease mortality rates and water hardness in North Dakota. S.D. J. Med., 42, 5–7.
Eisenberg, M.J. 1986. Magnesium deficiency and cardiac arrythmias. N. Y. State J. Med., 86, 133–135.
Faure, G. 1991. Principles and Applications of Inorganic Geochemistry. MacMillan, New York.
Gunther, T. 1986. Magnesium: cardiovascular biochemistry. Magnesium Bull., 8, 136–139.
Gyllerup, S., Lanke, J., Lindholm, L.H. and Schersten, B. 1991. Water hardness does not contribute substantially to the high coronary mortality in cold regions of Sweden. J. Intern. Med., 230, 487–492.
Gyntelberg, F. 1977. Coronary heart disease and physical activity. Nordic Council for Arctic Medical Research Report, 19, 64–69.
Hopps, H.C. and Feder, G.L. 1986. Chemical qualities of water that contribute to human health in a positive way. Sci. Total Environ., 54, 207–216.
Jeppesen, B.B. 1987. Greenland, a soft-water area with a low incidence of ischemic heart death. Magnesium, 6, 307–313.
Joensuu, T. 1989. Ischaemic heart disease leading to hospitalization or death in Finland 1972–1985. Health Services Research by the National Board of Health in Finland, 52, 1–202.
Karppanen, H. 1990. Epidemiologic evidence for considering magnesium deficiency as a risk factor for cardiovascular diseases. Magnesium Bull., 12, 80–86.
Karvonen, M.J. 1977. 15-year incidence of coronary heart disease in the east-west population study. Nordic Council for Arctic Medical Research Report, 19, 78–83.
Karvonen, S., Rimpelä, A. and Rimpelä, H. 1991. Säilyykö sepelvaltimotaudin itälänsi -ero myös tulevaisuudessa Suomessa? Duodecim, 107, 1853–1858.
Kobayashi, J. 1957. On geographical relations between the chemical nature of river water and death rate from apoplexy. Ber. Ohara Inst. fur Landwirtsch. Biol., 11, 12–21.
Lacey, R.F. and Shaper, A.G. 1984. Changes in water hardness and cardiovascular death rates. Intnl J. Epidemiology, 13, 18–24.
Lahermo, P., Ilmasti, M., Juntunen, R. and Taka, M. 1990. The Geochemical Atlas of Finland, Part 1. The Hydrogeochemical Mapping of Finnish Groundwater. Geological Survey of Finland, Espoo.
Leary, W.P. 1986. Content of magnesium in drinking water and deaths from ischaemic heart disease in white South Africans. Magnesium, 5, 150–153
Leary, W.P., Reyes, A.J. and Cockett, C.J. 1983. Magnesium and deaths ascribed to ischemic heart disease in South Africa. South Aft. Med. J., 64, 775–776.
Linderholm, H. and Westlund, K. (eds.), 1977. Symposium on coronary heart disease particularly with regard to the northern parts of the Nordic countries. Nordic Council for Medical Research Report, 19, 1–193.
Lowik, M.R.H., Groot, E.M. and Binnerts, W.T. 1982. Magnesium and public health: the impact of drinking water. In: Hemphill, H. (ed.), Trace Substances in Environmental Health. Proceedings of University of Missouri's Annual Conference on Trace Substances in Environmental Health, pp. 189–195. University of Missouri, Columbia.
Luoma, H., Aromaa, A. and Helminen, S. 1983. Risk of myocardial infarction in Finnish men in relation to fluoride, magnesium and calcium concentration in drinking water. Acta Med. Scand., 213, 171–176.
Masironi, R. 1979. Geochemistry and cardiovascular diseases. Phil. Trans. R. Soc. London (Biol.), 288, 193–203.
Masironi, R. 1987. Geochemistry, soils and cardiovascular diseases. Experientia, 43, 68–74.
Matthess, G. 1982. The Properties of Groundwater. J. Wiley and Sons, New York.
Morris, J.N., Crawford, M.D. and Heady, J.A. 1961. Hardness of local water supplies and mortality from cardiovascular diseases. Lancet, 1, 860–862.
National Academy of Sciences, 1979. Geochemistry of Water in Relation to Cardiovascular Disease. National Academy of Sciences, Washington, DC.
National Public Health Institute (Helsinki, Finland), 1982. Monitoring of trends and determinants of cardiovascular diseases in Finland (part of a joint WHO study) — The Monica Project. Publications of the National Public Health Institute, B3, 1–70.
Neri, L.C. and Johansen, H.L. 1978. Water hardness and cardiovascular mortality. Ann. N.Y. Acad. Sci., 304, 203–219.
Nikkari, T., Salo, M., Maatela, J. and Aromaa, A. 1983. Serum fatty acids in Finnish men. Atherosclerosis, 49, 139–148.
Nikkilä, E.A. and Rissanen, A. 1977. Familial occurrence of coronary risk factors. Nordic Council for Arctic Medical Research Report, 19, 18–21.
Piispanen, R. 1988. Prospects for geochemical-geomedical research in northern Finland. Arctic Med. Res., 47, 166–172.
Pocock, S.J., Shaper, A.G., Powell, P. and Packham, R.T. 1986. The British regional heart study: cardiovascular disease and water quality. In: Thornton, I. (ed.), Proceedings of the Ist International Conference of Geochemistry and Health, pp.141–157. Science Reviews Ltd., Northwood, UK.
Punsar, S. and Karvonen, M.J. 1979. Drinking water quality and sudden death: observations from West and East Finland. Cardiology, 64, 24–34.
Puska, P., Tuomilehto, J. and Virtamo, J. 1977. The North Karelia project — a comprehensive cardiovascular community control programme. Nordic Council for Arctic Medical Research Report, 19, 159–165.
Pyörälä, K., Punsar, S., Siltanen, P., Savolainen, E. and Sarna, S. 1977. The coronary heart disease morbidity of Helsinki policemen born in western and eastern Finland. Nordic Council for Arctic Medical Research Report, 19, 70–77.
Pyörälä, K. and Valkonen, T. 1981. The high ischaemic heart disease mortality in Finland —International comparisons, regional differences, trends and possible causes. In: Boström H. and Ljungstedt, N. (eds.), Medical Aspects of Mortality Statistics, Skandia International Symposia. Medical Aspects of Mortality Statistics, pp.37–57. Almqvist and Wicksell, Stockholm.
Reunanen, A., Aromaa, A., Pyörälä, K., Punsar, S., Maatela, J. and Knekt, P. 1983. The Social Insurance Institution's Coronary Heart Disease Study. Baseline data and 5-year mortality experience. Publications of the Social Insurance Institution, Finland, AL21, pp.1–120.
Rose, G. and Marmot, M.G. 1981. Social class and coronary heart disease: A clinical and epidemiological study. Br. Heart J., 45, 13–19.
Rylander, R., Bonevik, H. and Rubenowitz, E. 1991. Magnesium and calcium in drinking water and cardiovascular mortality. Scand. J. Work Environ. Health, 17, 91–94.
Salo, M.K. 1987. Fatty acids and platelet function in populations with different rates of ischemic heart disease. Acta Universitatis Tamperensis (ser. A), 219, 1–239.
Schechter, M. 1990. Beneficial effect of magnesium in acute myocardial infarction — A review of the literature. Magnesium Bull., 12, 1–5.
Schechter, M. and Hod, M. 1991. Magnesium therapy in aged patients with acute myocardial infarction. Magnesium Bull., 13, 7–9.
Shaper, A.G. 1984. Geographic variations in cardiovascular mortality in Great Britain. Br. Med. Bull., 40, 366–373.
Singh, R.B. 1990. Effect of dietary magnesium supplementation in the prevention of coronary heart disease and sudden cardiac death. Magnesium and Trace Elements, 9, 143–151.
Turlapaty, P.D.M.V. and Altura, B.M. 1980. Magnesium deficiency produced spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science, 208, 198–200.
Valkonen, T. and Notkola, V. 1977. Social environment and natural environment in relation to ischaemic heart disease mortality in Finland. Nordic Council for Arctic Medical Research Report, 19, 95–100.
Whang, R. and Ryder, K.W. 1990. Ionic disturbances in hospital practice: the case for magnesium. Magnesium Bull., 12, 122–126.
Witteman, J.C.M. and Grobbee, D.E. 1990. Calcium and magnesium in hypertension: current evidence. Magnesium Bull., 12, 87–97.
Woods, K.L., Fletcher, S., Roffe, C. and Haider, Y. 1992. Intravenous magnesium sulphate in suspected acute myocardial infarction: results of the second Leicester Intraveous magnesium Intervention Trial (LIMIT-2). Lancet, 339, 1553–1558.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Piispanen, R. Water hardness and cardiovascular mortality in Finland. Environ Geochem Health 15, 201–208 (1993). https://doi.org/10.1007/BF00146743
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00146743