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Associations Between Lead and Cadmium Exposure and Subclinical Cardiovascular Disease in U.S. Adults
Lin Liu1, Aimin Xu1,2, Bernard M Y Cheung3,4,5,6
1Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
Insights
Lead and cadmium exposure are linked to subclinical cardiovascular disease (CVD). This study highlights the association between these heavy metals and elevated cardiac biomarkers, emphasizing the need for preventive strategies.
Area of Science:
- Environmental Health
- Cardiovascular Disease Epidemiology
- Toxicology
Background:
- Subclinical cardiovascular disease (CVD) poses a significant health burden.
- The impact of environmental toxins like lead and cadmium on early CVD markers is not fully understood.
- Biomarkers such as high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-b-type natriuretic peptide (NT-proBNP) indicate cardiac stress.
Purpose of the Study:
- To investigate the association between blood lead and cadmium levels and elevated hs-cTnT and NT-proBNP in adults without diagnosed CVD.
- To explore potential disparities in these associations across demographic groups and kidney function levels.
Main Methods:
- Analysis of data from 10,197 participants in the National Health and Nutrition Examination Survey (NHANES, 1999-2004).
- Measurement of blood lead and cadmium using mass spectrometry and atomic absorption spectrometry.
- Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for elevated biomarkers.
Main Results:
- Elevated blood lead was associated with higher odds of elevated hs-cTnT (OR 1.45) and NT-proBNP (OR 1.66).
- Elevated blood cadmium showed associations with increased odds of elevated hs-cTnT (OR 1.33) and NT-proBNP (OR 1.39).
- The association between lead exposure and NT-proBNP was notably stronger in non-Hispanic Black individuals and those with impaired kidney function.
Conclusions:
- This study provides evidence linking lead and cadmium exposure to subclinical CVD markers.
- Findings underscore the importance of reducing environmental exposure to these heavy metals to mitigate cardiovascular risk.
- Targeted public health interventions are needed to protect vulnerable populations from heavy metal-induced cardiovascular damage.
Abstract:
The impact of lead and cadmium exposure on subclinical cardiovascular disease (CVD), indicated by elevated high-sensitivity cardiac troponin (hs-cTnT) and N-terminal pro b-type natriuretic peptide (NT-proBNP) remains uncertain. We analyzed data from participants aged 20 and older, without overt CVD, in the National Health and Nutrition Examination Survey (NHANES; 1999-2004). Elevated lead and cadmium levels were defined as 3.5 μg/dL and 1.0 μg/L (inductively coupled plasma mass spectrometry) and 3.8 μg/dL and 0.9 μg/L (atomic absorption spectrometry), respectively. Elevated hs-cTnT was ≥ 19 ng/L, and elevated NT-proBNP was ≥ 125 pg/mL. Multivariate logistic regression estimated the odds ratios (OR) and 95% confidence intervals (CI) for elevated biomarkers. Among 10,197 participants (mean age 48.8 years; 50.3% female), 5.3% had elevated hs-cTnT and 19.4% had elevated NT-proBNP. Elevated blood lead was associated with increased ORs for elevated hs-cTnT (OR 1.45, 95% CI 1.15-1.84) and NT-proBNP (OR 1.66, 95% CI 1.40-1.97). The corresponding ORs (95% CI) for elevated blood cadmium were 1.33 (1.02, 1.74) and 1.39 (1.18, 1.65). The effect of elevated blood lead on NT-proBNP was particularly pronounced among non-Hispanic Blacks (OR [95% CI], 3.26 [2.24, 4.74]) compared to Mexican Americans (1.46 [0.99, 2.17]) and non-Hispanic Whites (1.31 [1.02, 1.68]) and was stronger in individuals with impaired kidney function (OR [95% CI], 2.31 [1.43, 3.75]) compared to those with normal kidney function (1.44 [1.18, 1.75]). This study first reveals the association between lead and cadmium exposure and subclinical CVD, underscoring the need for targeted preventive measures to reduce cardiovascular risk and improve health outcomes.
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