Mineral Composition of Drinking Water and Cardiovascular Health
Summary
The mineral composition of drinking water, notably the concentrations of calcium and magnesium, has emerged as a factor influencing cardiovascular health at a population level. Water hardness, determined by levels of divalent cations such as Ca2+ and Mg2+, varies with geological substrate and treatment processes, creating regional differences in mineral intake. Epidemiological evidence suggests that higher concentrations of magnesium in drinking water may improve endothelial function, stabilise blood pressure and reduce the incidence of ischaemic events, while calcium contributes to vascular tone and myocardial contractility. Mechanistic studies indicate that these minerals act through modulation of electro-physiological signalling, regulation of vascular smooth muscle and attenuation of inflammatory pathways linked to atherogenesis. Public health interest has extended to low- and middle-income settings, where enhancing mineral content in water supplies could represent a cost-effective strategy to address suboptimal dietary intakes and reduce cardiovascular disease (CVD) burden. Ongoing research explores the balance between essential mineral benefits and potential confounding factors such as co-occurring contaminants or socio-economic determinants of health.
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Mineral Composition of Drinking Water and Cardiovascular Health publication trend
The graph below shows the total number of articles in mineral composition of drinking water and cardiovascular health across all publications each year (not limited to Nature Index journals).
Technical terms
Water hardness: A measure of the concentration of divalent metal cations, primarily calcium and magnesium, in water, expressed in millimoles per litre or as calcium carbonate equivalents.
Myocardial infarction: Necrosis of heart muscle tissue due to prolonged ischaemia, commonly known as a heart attack, resulting from obstruction of coronary blood flow.
Hazard ratio (HR): A measure used in survival analysis to compare the hazard rates of events (such as disease incidence) between two groups over time; an HR below 1 indicates reduced risk in the exposed group.
Bioavailability: The proportion of an ingested nutrient that is absorbed and utilised by the body, influenced by chemical speciation, competing ions and physiological factors.
References
- Calculation of the contribution of water to calcium intake in low‐ and middle‐income countries. Annals of the New York Academy of Sciences (2023).
- Calcium and magnesium in drinking water and risk of myocardial infarction and stroke—a population-based cohort study. American Journal of Clinical Nutrition (2022).
- The Relationship between Mortality from Cardiovascular Diseases and Total Drinking Water Hardness: Systematic Review with Meta-Analysis. Foods (2023).
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