Chronic exposure to low levels of lead, cadmium and arsenic through commonly used household items, air, water, soil and food is associated with an increased risk of cardiovascular disease, according to a new American Heart Association scientific statement published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
This scientific statement reviews evidence linking chronic exposure to low or moderate levels of three contaminant metals — lead, cadmium and arsenic — to cardiovascular diseases including coronary artery disease, stroke and peripheral artery disease. It highlights clinical and public health implications. Traditional risk factors for cardiovascular disease do not currently include environmental toxicants. The field of environmental cardiology identifies exposure to pollutants including contaminant metals as modifiable risks for cardiovascular disease.
“Large population studies indicate that even low-level exposure to contaminant metals is near-universal and contributes to the burden of cardiovascular disease, especially heart attacks, stroke, disease of the arteries to the legs and premature death from cardiac causes,” said Gervasio A. Lamas, M.D., FAHA, chair of the statement writing group and chairman of medicine and chief of the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami Beach, Florida.
“These metals interfere with essential biological functions and affect most populations on a global scale,” said vice chair of the statement writing group Ana Navas-Acien, M.D., Ph.D., a professor of environmental health sciences at Columbia University’s Mailman School of Public Health and the director of the Columbia University Northern Plains Superfund Research Program in New York City. “After exposure, lead and cadmium accumulate in the body and remain in bones and organs for decades. In the U.S. alone, one large study suggested that more than 450,000 deaths annually could be attributed to lead exposure.”
What are the cardiovascular risks of contaminant metals?
The scientific statement outlines global epidemiologic research confirming that lead, cadmium and arsenic are associated with premature death, due in large part to increased cardiovascular disease risk. The global research includes:
- A 2021 American Heart Association scientific statement recognized exposure to toxic metals as a non-conventional risk factor for peripheral artery disease.
- A 2018 review published in the British Medical Journal assessed 37 studies representing nearly 350,000 people from more than a dozen countries. The review reported that higher urine levels of arsenic and blood levels of lead and cadmium were associated with 15%-85% higher risk for stroke and heart disease.
- One study in China found that higher levels of lead in the blood were associated with carotid plaque in people with Type 2 diabetes. Another found that cadmium and arsenic were associated with a higher rate of heart disease and ischemic stroke.
- In Spain, a general population study found that cadmium in urine was associated with increased rates of newly diagnosed cardiovascular disease.
