TY - JOUR
T1 - Contaminant Metals as Cardiovascular Risk Factors
T2 - A Scientific Statement From the American Heart Association
AU - Lamas, Gervasio A.
AU - Bhatnagar, Aruni
AU - Jones, Miranda R.
AU - Mann, Koren K.
AU - Nasir, Khurram
AU - Tellez-Plaza, Maria
AU - Ujueta, Francisco
AU - Navas-Acien, Ana
N1 - Funding Information:
The PINNACLE FLX (Protection Against Embolism for Non-valvular AF [Atrial Fibrillation] Patients: Investigational Device Evaluation of the Watchman FLX LAA [Left Atrial Appendage] Closure Technology) trial was sponsored and funded by Boston Scientific, Inc (Marlborough, MA).
Publisher Copyright:
© 2023 The Authors. Published on behalf of the American Heart Association, Inc.
PY - 2023/2/21
Y1 - 2023/2/21
N2 - Exposure to environmental pollutants is linked to increased risk of cardiovascular disease. Beyond the extensive evidence for particulate air pollution, accumulating evidence supports that exposure to nonessential metals such as lead, cadmium, and arsenic is a significant contributor to cardiovascular disease worldwide. Humans are exposed to metals through air, water, soil, and food and extensive industrial and public use. Contaminant metals interfere with critical intracellular reactions and functions leading to oxidative stress and chronic inflammation that result in endothelial dysfunction, hypertension, epigenetic dysregulation, dyslipidemia, and changes in myocardial excitation and contractile function. Lead, cadmium, and arsenic have been linked to subclinical atherosclerosis, coronary artery stenosis, and calcification as well as to increased risk of ischemic heart disease and stroke, left ventricular hypertrophy and heart failure, and peripheral artery disease. Epidemiological studies show that exposure to lead, cadmium, or arsenic is associated with cardiovascular death mostly attributable to ischemic heart disease. Public health measures reducing metal exposure are associated with reductions in cardiovascular disease death. Populations of color and low socioeconomic means are more commonly exposed to metals and therefore at greater risk of metal-induced cardiovascular disease. Together with strengthening public health measures to prevent metal exposures, development of more sensitive and selective measurement modalities, clinical monitoring of metal exposures, and the development of metal chelation therapies could further diminish the burden of cardiovascular disease attributable to metal exposure.
AB - Exposure to environmental pollutants is linked to increased risk of cardiovascular disease. Beyond the extensive evidence for particulate air pollution, accumulating evidence supports that exposure to nonessential metals such as lead, cadmium, and arsenic is a significant contributor to cardiovascular disease worldwide. Humans are exposed to metals through air, water, soil, and food and extensive industrial and public use. Contaminant metals interfere with critical intracellular reactions and functions leading to oxidative stress and chronic inflammation that result in endothelial dysfunction, hypertension, epigenetic dysregulation, dyslipidemia, and changes in myocardial excitation and contractile function. Lead, cadmium, and arsenic have been linked to subclinical atherosclerosis, coronary artery stenosis, and calcification as well as to increased risk of ischemic heart disease and stroke, left ventricular hypertrophy and heart failure, and peripheral artery disease. Epidemiological studies show that exposure to lead, cadmium, or arsenic is associated with cardiovascular death mostly attributable to ischemic heart disease. Public health measures reducing metal exposure are associated with reductions in cardiovascular disease death. Populations of color and low socioeconomic means are more commonly exposed to metals and therefore at greater risk of metal-induced cardiovascular disease. Together with strengthening public health measures to prevent metal exposures, development of more sensitive and selective measurement modalities, clinical monitoring of metal exposures, and the development of metal chelation therapies could further diminish the burden of cardiovascular disease attributable to metal exposure.
KW - AHA Scientific Statements
KW - arsenic
KW - cadmium
KW - cardiac risk factors
KW - coronary disease
KW - heavy metals
KW - lead
KW - myocardial infarction
KW - Arsenic
KW - Humans
KW - American Heart Association
KW - Myocardial Ischemia/complications
KW - Lead/adverse effects
KW - Cadmium/adverse effects
KW - Environmental Exposure/adverse effects
KW - Cardiovascular Diseases/etiology
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U2 - 10.1161/JAHA.122.026295
DO - 10.1161/JAHA.122.026295
M3 - Article
C2 - 37306302
AN - SCOPUS:85164242495
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 4
M1 - e026295
ER -