And Test Your Toenails for Nicotine

The Nurses’ Health Study has provided lots of information on different topics, but perhaps one of the more obscure is the collection of toenail clippings from some 62,000 participants (all women) in 1982. Between 2 and 16 years later there were over 900 cases of coronary heart disease diagnosed. Each case was matched with two participants without cardiovascular disease, but of the same age and date of toenail collection. The findings are published in the American Journal of Epidemiology.

A statistically-significant link was found between the level of nicotine in the toenails and the likelihood of coronary heart disease. The 20% of women with the highest toenail nicotine content were about 3.5 times more likely to develop coronary disease than the 20% with the lowest levels. This finding persisted even after making statistical allowances for the number of cigarettes smoked and passive smoking exposure.

It seems that toenail nicotine levels are predictive of coronary heart disease in women, even after adjustment for a history of cigarette smoking. Do you suppose that your family physician would order this test? And if so, would Medicare pay for it?