Cadmium exposure and incident peripheral arterial disease

Area of Science:

• Environmental Health
• Cardiovascular Epidemiology
• Toxicology

Background:

• Cadmium exposure is a potential risk factor for cardiovascular disease.
• Previous studies suggest an association between cadmium and peripheral arterial disease (PAD), but lacked prospective data.
• This research addresses the need for prospective evidence on cadmium and incident PAD.

Purpose of the Study:

• To investigate the association between urine cadmium concentrations and the incidence of peripheral arterial disease (PAD).
• To evaluate cadmium as a potential risk factor for cardiovascular disease in a large population-based cohort.

Main Methods:

• A prospective cohort study of 2864 American Indian adults (45-74 years) from the Strong Heart Study (1989-1999).
• Urine cadmium levels were measured using inductively coupled plasma mass spectrometry and corrected for creatinine.
• Incident PAD was defined by ankle-brachial index (<0.9 or >1.4) and analyzed using Cox-proportional hazards models.

Main Results:

• A total of 470 incident PAD cases were identified during the follow-up period.
• Higher urine cadmium concentrations were independently associated with increased PAD risk after adjusting for cardiovascular risk factors.
• Hazard ratios for incident PAD increased significantly with higher cadmium levels (80th vs. 20th percentile: 1.41; highest vs. lowest tertile: 1.96).

Conclusions:

• Urine cadmium, a biomarker of long-term exposure, is independently associated with incident peripheral arterial disease (PAD).
• These findings provide prospective evidence supporting cadmium as a cardiovascular disease risk factor.
• Cadmium exposure may contribute to the development of PAD, emphasizing the need for exposure reduction.