1. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Strong Heart Study clinic visits, follow-up, and data used in the present study. * Urinary arsenic concentrations were only available for 380 participants. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios for cardiovascular disease and coronary heart disease incidence and mortality, by urinary arsenic concentration (n= 3575). Solid lines represent adjusted hazard ratios based on restricted quadratic splines for the log-transformed sum of inorganic and methylated arsenic species, with knots at the 10th, 50th, and 90th percentiles (3.8, 9.7, and 24.0 µg/g creatinine, respectively). The dotted lines represent upper and lower 95% CIs. The reference was set at the 10th percentile of the arsenic distribution (3.8 µg/g creatinine). Adjustment factors were the same as those for model 2 in Tables 1 and 2. The bars represent a histogram of urinary arsenic distribution among participants (the extreme tails of the histogram were truncated because only 1 participant had a urinary arsenic level 54.6 µg/g creatinine). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios for stroke incidence, by urinary arsenic concentration (n= 3575). The solid line represents the adjusted hazard ratio based on restricted quadratic splines for the log-transformed sum of inorganic and methylated arsenic species, with knots at the 10th, 50th, and 90th percentiles (3.8, 9.7, and 24.0 µg/g creatinine, respectively). The dotted lines represent upper and lower 95% CIs. The reference was set at the 10th percentile of the arsenic distribution (3.8 µg/g creatinine). Adjustment factors were the same as those for model 2 in Tables 1 and 2. The bars represent a histogram of urinary arsenic distribution among participants (the extreme tails of the histogram were truncated because only 1 participant had a urinary arsenic level 54.6 µg/g creatinine). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

4. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios and 95% CIs for cardiovascular disease and coronary heart disease mortality when an interquartile range of urinary arsenic concentrations is compared, by participant characteristics at baseline (n= 3575). Hazard ratios for cardiovascular disease and coronary heart disease mortality were stratified by each subgroup of interest, and associated P values for interaction were obtained from stratified Cox proportional hazards models with log-transformed arsenic (sum of inorganic and methylated arsenic species) as a continuous variable, adjusted for the same covariates as those in model 2 in 1 and 2. The interquartile range of urinary arsenic concentrations was 5.8 to 15.7 µg/g creatinine. For cardiovascular disease and coronary heart disease mortality hazard ratios by methylation indices (below and above the median proportions of inorganic arsenic, MMA, and DMA), the data set was restricted to participants with detectable inorganic arsenic, MMA, and DMA concentrations (n = 3381). For this subset, the corresponding urinary arsenic interquartile range was 6.1 to 16.2 µg/g creatinine. DMA = dimethylarsinate; HR = hazard ratio; MMA = monomethylarsonate. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

5. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios and 95% CIs for cardiovascular disease incidence when an interquartile range of urinary arsenic concentrations is compared, by participant characteristics at baseline (n= 3575). Hazard ratios for cardiovascular disease incidence (fatal and nonfatal events) were stratified by each subgroup of interest, and associated P values for interaction were obtained from stratified Cox proportional hazards models with log-transformed arsenic (sum of inorganic and methylated arsenic species) as a continuous variable, adjusted for the same covariates as those in model 2 in the main analysis. The interquartile range of urinary arsenic concentrations was 5.8 to 15.7 µg/g creatinine. For cardiovascular disease incidence hazard ratios by methylation indices (below and above median proportions of inorganic arsenic, MMA, and DMA), the data set was restricted to participants with detectable inorganic arsenic, MMA, and DMA concentrations (n = 3381). For this subset, the corresponding urinary arsenic interquartile range was 6.1 to 16.2 µg/g creatinine. DMA = dimethylarsinate; HR = hazard ratio; MMA = monomethylarsonate. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

6. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios and 95% CIs for coronary heart disease incidence when an interquartile range of urinary arsenic concentrations is compared, by participant characteristics at baseline (n= 3575). Hazard ratios for coronary heart disease incidence (fatal and nonfatal events) were stratified by each subgroup of interest, and associated P values for interaction were obtained from stratified Cox proportional hazards models with log-transformed arsenic (sum of inorganic and methylated arsenic species) as a continuous variable, adjusted for the same covariates as those in model 2 in the main analysis. The interquartile range of urinary arsenic concentrations was 5.8 to 15.7 µg/g creatinine. For coronary heart disease hazard ratios by methylation indices (below and above median proportions of inorganic arsenic, MMA, and DMA), the data set was restricted to participants with detectable inorganic arsenic, MMA, and DMA concentrations (n = 3381). For this subset, the corresponding urinary arsenic interquartile range was 6.1 to 16.2 µg/g creatinine. DMA = dimethylarsinate; HR = hazard ratio; MMA = monomethylarsonate. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

7. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios and 95% CIs for stroke incidence when an interquartile range of urine arsenic concentrations is compared, by participant characteristics at baseline (n= 3575). Hazard ratios for stroke incidence (fatal and nonfatal events) were stratified by each subgroup of interest, and associated P values for interaction were obtained from stratified Cox proportional hazards models with log- transformed arsenic (sum of inorganic and methylated arsenic species) as a continuous variable, adjusted for the same covariates as those in model 2 in the main analysis. The interquartile range of urine arsenic concentrations was 5.8 to 15.7 µg/g creatinine. For stroke incidence hazard ratios by methylation indices (below and above median proportions of inorganic arsenic, MMA, and DMA), the data set was restricted to participants with detectable inorganic arsenic, MMA, and DMA concentrations (n = 3381). For this subset, the corresponding urine arsenic interquartile range was 6.1 to 16.2 µg/g creatinine. DMA = dimethylarsinate; HR = hazard ratio; MMA = monomethylarsonate. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

8. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios for cardiovascular disease incidence and mortality, stratified by study region. The lines represent adjusted hazard ratios based on restricted quadratic splines for the log-transformed sum of inorganic and methylated arsenic species, with knots at the 10th, 50th, and 90th percentiles (3.8, 9.7, and 24.0 µg/g creatinine, respectively). The solid lines indicate participants from Arizona, the dotted lines indicate those from the Dakotas, and the dashed lines indicate those from Oklahoma. The reference was set at the 10th percentile of the arsenic distribution (3.8 µg/g creatinine). Adjustment factors were the same as those for model 2 in Tables 1 and 2. The bars represent a histogram of urinary arsenic distribution among participants (the extreme tails of the histogram were truncated because only 1 participant had a urinary arsenic level 54.6 µg/g creatinine). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

9. Date of download: 5/28/2016 From: Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease: A Prospective Cohort Study Ann Intern Med. Published online September 24, 2013. doi:10.7326/0003-4819-159-10-201311190-00719 Hazard ratios for cardiovascular disease incidence and mortality, stratified by diabetes status. The lines represent adjusted hazard ratios based on restricted quadratic splines for the log-transformed sum of inorganic and methylated arsenic species, with knots at the 10th, 50th, and 90th percentiles (3.8, 9.7, and 24.0 µg/g creatinine, respectively). The solid lines indicate participants with diabetes at baseline, and the dotted lines indicate those without diabetes at baseline. The reference was set at the 10th percentile of the arsenic distribution (3.8 µg/g creatinine). Adjustment factors were the same as those for model 2 in Tables 1 and 2. The bars represent a histogram of urinary arsenic distribution among participants (the extreme tails of the histogram were truncated because only 1 participant had a urinary arsenic level 54.6 µg/g creatinine). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians