Abstract
This systematic review evaluates and synthesizes existing scientific evidence on the impact of high hardness water consumption on the incidence of myocardial infarction, with a focus on dissolved minerals, such as calcium and magnesium. Through the PICO methodology and following the PRISMA 2020 guideline, six main studies were selected from a total of 202 articles. The results show a significant protective effect of water hardness, mainly attributable to the presence of magnesium and calcium, essential elements for cardiovascular health. Five out of six studies showed an inverse correlation between water hardness and risk of myocardial infarction. Despite the promising results, the study has some limitations, including the restriction to three main databases and the exclusion of studies in languages other than English, which may have omitted relevant data. In addition, the small size of some of the populations analyzed may limit the generalizability of the results.

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Copyright (c) 2025 Fabiana Polichetti, Michele Virgolesi, Vincenza Giordano, Lorenzo Mercurio, Teresa Rea