Selenium and large artery structure and function: a 10-year prospective study



Despite selenium’s beneficial effects in counteracting oxidative stress, inflammation, and vascular endothelial dysfunction, controversial results exist regarding the long-term associations between selenium and atherosclerosis, arterial stiffness, and hypertension. We investigated in normal and selenium-deficient groups (and the total group), whether serum selenium relates to measures of large artery structure and function over 10 years.


This longitudinal study included black adults from rural and urban areas in South Africa. Serum selenium and blood pressure were measured at baseline (N = 987). At follow-up, carotid intima media thickness (IMT), cross-sectional wall area (CSWA), carotid-femoral pulse wave velocity (c-fPWV), and blood pressure were measured (N = 718). Selenium deficiency was classified as serum levels < 8 µg/100 ml.


In multivariable-adjusted regression analyses performed in the normal selenium group, c-fPWV after 10 years was negatively associated with baseline selenium (β = − 0.09; p = 0.016). In the normal selenium group, baseline (but not 10 years) blood pressure also associated negatively with baseline selenium (β = − 0.09; p = 0.007). Both IMT (β = 0.12; p = 0.001) and CSWA (β = 0.10; p = 0.003) after 10 years associated positively with baseline selenium in the total, normal, and selenium-deficient groups.


We found a long-term vascular protective association of selenium on arterial stiffness and blood pressure in Africans with normal selenium levels, supporting the notion that selenium fulfills a vascular protective role. In contrast, we found a potential detrimental association between selenium and carotid wall thickness, particularly evident in individuals within the highest quartile of serum selenium.

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We would like to thank all the participants, students, and supporting staff of the PURE study and particularly: (1) PURE-SA research team, field workers, and office staff at the North-West University, South Africa. (2) PURE-International: The PURE project office staff at the Population Health Research Institute (PHRI), Hamilton Health Sciences, and McMaster University, ON, Canada.


This project was funded by the South African Netherlands Research Programme on Alternatives in Development, North-West University, Population Health Research Institute, Roche Diagnostics (South Africa) and South African Medical Research Council, South African National Research Foundation (NRF), and South African Sugar Association (SASA) for the analyses (Grant number: Project 249). Opinions expressed and conclusions are those of the authors and are not necessarily to be attributed to the NRF.

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RS was responsible for the planning, writing, and composition of the manuscript as well as the statistical analyses. CMCM, AES, and JMvR gave recommendations for the framework, writing, and composition of the manuscript as well as the methodology. They also supervised the statistical analyses and helped with the formulation of the tables and figures.

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Correspondence to Catharina M. C. Mels.

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Swart, R., Schutte, A.E., van Rooyen, J.M. et al. Selenium and large artery structure and function: a 10-year prospective study. Eur J Nutr 58, 3313–3323 (2019).

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  • Carotid intima media thickness
  • Atherosclerosis
  • Pulse wave velocity
  • Arterial stiffness
  • Blood pressure
  • Micronutrient