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Impact of environmental heavy metal exposure on cardiovascular disease mortality
Karthik Gonuguntla1, Waleed Alruwaili2, Harshith Thyagaturu2
1Department of Cardiology, Hartford Hospital Healthcare, Norwich, CT, USA.
Insights
Heavy metal exposure, including lead and cadmium, is linked to increased cardiovascular disease (CVD) mortality. However, mercury exposure showed an inverse association with CVD deaths in a U.S. adult population study.
Area of Science:
- Environmental Health
- Cardiovascular Science
- Toxicology
Background:
- Cardiovascular disease (CVD) is a leading global cause of death.
- Heavy metal exposure, specifically lead (Pb), cadmium (Cd), and mercury (Hg), is a significant environmental risk factor for CVD.
- These metals induce cardiovascular toxicity through oxidative stress, inflammation, endothelial dysfunction, and lipid metabolism disruption.
Purpose of the Study:
- To investigate the association between blood concentrations of lead, cadmium, and mercury and cardiovascular mortality.
- To analyze data from a representative U.S. adult population.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2018.
- Analyzed blood levels of Pb, Cd, and Hg, categorized into quartiles.
- Employed Cox proportional hazards models, adjusting for covariates, to assess the relationship with CVD mortality.
Main Results:
- Included 55,081 participants; 4.5% experienced CVD mortality.
- Higher blood lead and cadmium levels (3rd/4th quartiles) were significantly associated with increased CVD mortality.
- Higher blood mercury levels (3rd/4th quartiles) showed an inverse association with CVD mortality.
Conclusions:
- Blood lead and cadmium are positively associated with cardiovascular mortality in U.S. adults.
- Blood mercury exhibits an inverse association with cardiovascular mortality.
- Highlights the importance of monitoring environmental metal exposure for cardiovascular health implications.
Background:
Cardiovascular disease (CVD) is the primary cause of mortality worldwide, and heavy metal exposure, including lead (Pb), cadmium (Cd), and mercury (Hg), significantly impacts this global burden of CVD. Heavy metal-related cardiovascular toxicity results from their ability to induce oxidative stress, inflammation, endothelial dysfunction, and dysregulation of lipid metabolism. We aimed to investigate the association between blood concentrations of Pb, Cd, and Hg and cardiovascular mortality in a representative U.S. adult population.
Method:
Using the 1999-2018 National Health and Nutrition Examination Survey (NHANES) data, we examined the association of blood Pb, Cd, and Hg levels with CVD mortality. Pb, Cd, and Hg levels were transformed into quartiles. Metal levels were categorized into quartiles, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs), adjusting for demographic, clinical, and lifestyle covariates.
Results:
We included 55,081 participants between 1999 and 2018, of whom 4.5 % (n = 2402) experienced CVD-related death. Those with CVD mortality were more likely to be male (52 %), White (78 %), and to have a higher prevalence of hypertension, diabetes, obesity, and prior CVD, They also had significantly higher mean levels of Pb (2.57 vs. 1.59 μg/L, p < 0.01) and Cd (0.68 vs. 0.51 μg/L, p < 0.01) but lower mean levels of Hg (1.36 vs. 1.58 μg/L, p < 0.01). In multivariable models, higher Pb (3rd and 4th quartiles) and Cd (4th quartile) levels were significantly associated with increased CVD mortality, whereas higher Hg levels (3rd and 4th quartiles) were inversely associated with CVD mortality.
Conclusions:
In this nationally representative cohort, blood lead and cadmium were positively associated with cardiovascular mortality, whereas mercury showed an inverse association. These findings highlight the need for continued monitoring of environmental metal exposures and their potential cardiovascular implications.
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