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Metal exposure in heart disease.

Berthold Hocher1

  • 1Department of Medicine, University Medical Centre Mannheim, University of Heidelberg, Heidelberg, Germany; Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China; IMD Institut Für Medizinische Diagnostik Berlin-Potsdam GbR, Berlin, Germany; Institute of Reproductive and Stem Cell Engineering, NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Science, Central South University, Changsha, China.

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Toxic metals like lead, cadmium, and arsenic are linked to increased coronary heart disease (CHD) risk. Reducing environmental exposure is crucial for cardiovascular health and prevention.

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Area of Science:

  • Environmental Health
  • Cardiovascular Medicine
  • Toxicology

Background:

  • Coronary heart disease (CHD) is a major global health concern.
  • Classical risk factors are well-established, but environmental exposures, particularly toxic metals, are increasingly implicated in cardiovascular risk.
  • Epidemiological studies suggest associations between toxic metals and adverse cardiovascular outcomes.

Purpose of the Study:

  • To review current literature on the association between specific toxic metals (lead, cadmium, arsenic, mercury, chromium) and CHD.
  • To emphasize epidemiological evidence, mechanistic insights, and clinical implications of toxic metal exposure on cardiovascular health.
  • To explore exposure pathways, biomarkers, vascular mechanisms, and prevention strategies.

Main Methods:

  • A narrative review of PubMed-indexed literature.
  • Inclusion of major human observational studies, experimental data, and translational reports.
  • Focus on studies addressing exposure, biomarkers, vascular mechanisms, and prevention related to toxic metals and CHD.

Main Results:

  • Strong evidence links chronic exposure to lead, cadmium, and arsenic with increased risks of hypertension, atherosclerotic cardiovascular disease, and cardiovascular mortality.
  • Evidence for mercury and chromium is more variable and depends on context.
  • Mechanistic studies indicate metals promote oxidative stress, inflammation, endothelial dysfunction, and atherogenesis.

Conclusions:

  • Toxic metals are plausible, potentially underrecognized contributors to cardiovascular disease.
  • Clinical consideration of heavy metal exposure is warranted for specific CHD patients.
  • Prevention strategies should focus on reducing environmental and occupational exposures to toxic metals.