In men, low serum zinc levels were associated with a 94% increased risk of all-cause mortality and high serum zinc concentrations were inversely associated with CVD risk, while no significant associations were observed in women.
Key Findings
Results
Low serum zinc levels were associated with a 94% increased risk of all-cause mortality in men.
Hazard ratio of 1.94 (95% CI = 1.03–3.65) for all-cause mortality in men with low serum zinc
Analysis used multivariable Cox proportional hazard models
Study population consisted of 3,353 participants aged 30 years or older without a history of CVD
Data were sourced from the fourth phase of the Tehran Lipid and Glucose Study (TLGS), conducted between 2009 and 2011
Follow-up period was approximately 10 years
Results
High serum zinc concentrations were associated with a reduced risk of CVD events in men.
Hazard ratio of 0.66 (95% CI = 0.46–0.93) for CVD events in men with high serum zinc
This represents a approximately 34% reduced risk of CVD events
Association was observed after multivariable adjustment using Cox proportional hazard models
The association was specific to men and not observed in women
Results
No significant associations between serum zinc concentration and CVD events, CVD mortality, or all-cause mortality were observed in women.
The study explicitly tested for sex-specific differences in the association between serum zinc and cardiovascular outcomes
Findings suggest a sex-specific prospective association of serum zinc with cardiovascular outcomes
Women were included in the same cohort of 3,353 participants aged 30 years or older
The absence of association in women contrasts with statistically significant findings in men
Methods
The study population was drawn from a population-based cohort in Tehran, Iran, with a 10-year prospective follow-up.
3,353 participants were included, all aged 30 years or older
Participants had no history of CVD at baseline
Data were from the fourth phase of the Tehran Lipid and Glucose Study (TLGS), 2009–2011
Outcomes examined included CVD events, CVD mortality, and all-cause mortality
Multivariable Cox proportional hazard models were used to assess associations
Background
Zinc was highlighted as an essential trace element with a significant role in vascular function, motivating the investigation of its association with cardiovascular outcomes.
The study was designed to investigate potential associations between serum zinc concentration and CVD events, CVD mortality, and all-cause mortality
The study also aimed to consider possible sex-specific differences in these associations
Serum zinc concentration was used as the exposure measure
What This Means
This research followed over 3,300 adults in Tehran, Iran, for approximately 10 years to examine whether the amount of zinc in their blood was related to their risk of heart disease or death. At the start of the study, none of the participants had a history of cardiovascular disease. The researchers measured serum zinc levels and then tracked who developed heart disease or died over the follow-up period, using statistical models to account for other health factors.
The study found that among men, having low zinc levels in the blood was associated with nearly double the risk of dying from any cause, while having high zinc levels was linked to about a one-third lower risk of experiencing a cardiovascular event such as a heart attack or stroke. Interestingly, no such associations were found in women, suggesting that the relationship between zinc and cardiovascular outcomes may differ between the sexes.
This research suggests that serum zinc concentration may be a relevant factor in cardiovascular and overall mortality risk, at least in men. The findings highlight the potential importance of monitoring zinc status as part of cardiovascular health assessment, particularly in male populations. However, as this is an observational study, it cannot prove that zinc levels directly cause changes in cardiovascular risk, and further research would be needed to understand the underlying mechanisms and whether zinc supplementation or dietary changes could affect outcomes.
Ghafouri-Taleghani F, Bahadoran Z, Azizi F. (2026). Sex-Specific Prospective Association of Serum Zinc Concentration with Cardiovascular Disease and Mortality: A 10-Year Population-Based Cohort Study.. Journal of cardiovascular translational research. https://doi.org/10.1007/s12265-026-10789-1