Heart Failure Risk and Selenium Deficiency

Low plasma selenoprotein P levels are associated with a higher risk of heart failure in a Swedish population [Jujic 2023].

Heart rate
Selenium deficiency in heart failure patients is significantly associated with increased risk of cardiovascular mortality, impaired exercise capacity, and poorer quality of life [Bomer 2020].
Selenoprotein P is the primary protein transporter of selenium in the blood.

Plasma and serum selenoprotein P concentrations are useful biomarkers of selenium status in individuals with relatively low selenium intakes because selenoprotein P responds to different intake forms of selenium [Hurst 2010].

Selenium deficiency – defined as serum selenium concentrations below 70 mcg/L – has been associated with more severe symptoms of heart failure, poorer exercise capacity, and poorer quality of life. Sub-optimal serum selenium concentrations of 70–100 mcg/L have similar adverse associations, suggesting that values less than 100 mcg/L, might be considered abnormal [Bomer 2020].

Selenoprotein P and Risk of Heart Failure

In the Swedish “Malmö Preventive Project” cohort (n=18,240), researchers measured selenoprotein P concentration in 5060 randomly selected individuals. The researchers then excluded individuals with existing heart failure (n = 230) and individuals with missing data on co-variates included in the regression analysis (n = 27). This action resulted in complete data for 4803 subjects (29.1% women, mean age 69.6 years, 19.7% smokers) [Jujic 2023].

The researchers observed that for each one standard deviation increment in selenoprotein P levels, there was an associated lower risk of incident heart failure during a median follow-up period of 14.7 years. In sex-specific analyses, the association between each 1 standard deviation increment of selenoprotein P was present in men but not in women. Individuals, male and female combined, in the lowest selenoprotein P quintile were at the highest risk of heart failure compared to quintiles 2-5 [Jujic 2023].

The mean value of selenoprotein P concentration in the lowest quintile was 3.5 mg/L. This value corresponds to a serum selenium concentration considerably below 70 mcg/L [Jujic 2023].

Definition of Heart Failure

The American Heart Association defines heart failure as a condition in which the heart cannot keep up with its workload. In heart failure, the body’s organs and tissues may not get the oxygen they need [AHA 2023].

In the United States, there are an estimated six million patients with heart failure. Approximately one-half of heart failure hospitalizations are heart failure with reduced ejection fraction (HFrEF). The other one-half are heart failure with preserved ejection fraction (HFpEF) [Benjamin 2018].

At baseline in the current study, Jujic et al used International Classification of Diseases codes gathered from the Swedish Hospital Discharge Registry as well as from local hospital and study registries to characterize incident heart failure and prevalent heart failure. Incident heart failure patients experienced a fatal or non-fatal episode of heart failure during the study follow-up period. Prevalent heart failure patients, excluded from the statistical analysis, were individuals who presented at the study baseline with a previous fatal or non-fatal episode of heart failure [Jujic 2023].

Conclusion: Heart Failure risk and low Selenoprotein P

Selenoprotein P acts as a selenium transporter. It is essential in selenium metabolism and storage. Selenoprotein P concentrations correlate closely with serum selenium levels and are a functional index of selenium status [Jujic 2023].

Low selenoprotein P levels were associated with a higher risk of incident heart failure in a general population [Jujic 2023].

Adjustment for diabetes status shows that the association of low selenoprotein P level and higher risk of incident heart failure was independent of diabetes status [Jujic 2023].

There was no apparent interaction between selenoprotein P level and smoking [Jujic 2023].

There was an association between higher selenoprotein P concentrations and lower risk of heart failure only in the male study participants; however, more than two thirds of the study population was male. There were significantly lower numbers of female study participants in both cases and controls. Accordingly, heart health benefits of selenium in females cannot be excluded. High selenium levels have previously been associated with reduced risk of mortality in women [Jujic 2023].


American Heart Association. What is Heart Failure? 2023. Retrieved from https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure

Benjamin EJ, Virani SS, Callaway CW. Heart disease and stroke statistics: 2018 update. Circulation 2018;137:e67–492.

Bomer N, Grote Beverborg N, Hoes MF, Streng KW, Vermeer M, Dokter MM, IJmker J, Anker SD, Cleland JGF, Hillege HL, Lang CC, Ng LL, Samani NJ, Tromp J, van Veldhuisen DJ, Touw DJ, Voors AA, van der Meer P. Selenium and outcome in heart failure. Eur J Heart Fail. 2020 Aug;22(8):1415-1423.

Hurst R, Armah CN, Dainty JR, Hart DJ, Teucher B, Goldson AJ, Broadley MR, Motley AK, Fairweather-Tait SJ. Establishing optimal selenium status: results of a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2010 Apr;91(4):923-31.

Jujic A, Molvin J, Schomburg L, Hartmann O, Bergmann A, Melander O, Magnusson M. Selenoprotein P deficiency is associated with higher risk of incident heart failure. Free Radic Biol Med. 2023 Jul 7;207:11-16.

The information presented in this review article is not intended as medical advice and should not be used as such.

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