In a recently published article in the European Journal of Heart Failure, the selenium and heart failure group observed a novel finding and reported a significant association between selenium concentrations and new-onset heart failure in a large prospective cohort study. Per increase of 10 µg/l of selenium concentrations was associated with on average 18% lower risk of heart failure event. This finding adds a new exciting layer of evidence to the role of selenium in the progression of heart failure as reported previously by the same group.
(Under)nutrition has a major impact on the human heart. An imbalance of circulating molecules such as minerals and trace elements (e.g. iron, iodine and zinc) in the patient’s blood is closely related to the development and progression of heart failure. It has been shown that up to 50% of patients with heart failure suffer from some form of malnutrition, such as micronutrient deficiency
Selenium is a micronutrient similar to iron or iodine. Selenium is indispensable as a building block for the so-called selenoproteins. These proteins play an important role as antioxidants, but also have roles in the regulation of thyroid hormone, inflammation or processes related to cancer development. Selenium can be found in many foods, both animal (fish and meat) and vegetable products as well as in nuts. However, it cannot be made in the human body.
The group has demonstrated previously that approximately 25% of patients with heart failure have selenium concentrations below the clinical reference value (<70 µg/l) and that this was associated with poorer quality of life, poor exercise tolerance and a poorer prognosis compared to those without deficiency. Selenium deficiency is especially common in older patients and can be observed more often in women with more severe signs and symptoms of heart failure. In addition, the adverse effects of low selenium already appeared to manifest themselves at sub-optimal concentrations of selenium (<100 µg/l), which occurs in approximately 70% of patients with heart failure in Europe.
The most recent research conducted in the PREVEND (Prevention of Renal and Vascular End-stage Disease) cohort shows that the Dutch (Groningen) general population has a relatively low blood selenium concentration. This is partly due to the relatively low amount of selenium in the soil in Europe compared to, for example, America. As a result, food products grown in Europe contain less selenium than those from North or South America.
It was especially the non-smoking people with above-average selenium concentrations (15% of the total population) that had a lower risk of developing heart failure. This group with optimal selenium was also found to have a lower risk of death. People with too low selenium levels showed more often features of the metabolic syndrome (higher BMI, higher glucose, and higher inflammatory values) and smoked more often.
Well-designed clinical studies are now needed to determine whether optimizing blood selenium is a potential treatment option for people with heart failure, especially in patients who have a too low selenium level.
The full open-access article can be found here.
“Especially the non-smoking people with above-average selenium concentrations had a lower risk of developing heart failure”