Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis

Abstract

ObjectiveTo conduct a systematic review and meta-analysis of epidemiological studies investigating the association of arsenic, lead, cadmium, mercury, and copper with cardiovascular disease.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, and Web of Science searched up to December 2017.Review methodsStudies reporting risk estimates for total cardiovascular disease, coronary heart disease, and stroke for levels of arsenic, lead, cadmium, mercury, or copper were included. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks were standardised to a common scale and pooled across studies for each marker using random effects meta-analyses.ResultsThe review identified 37 unique studies comprising 348 259 non-overlapping participants, with 13 033 coronary heart disease, 4205 stroke, and 15 274 cardiovascular disease outcomes in aggregate. Comparing top versus bottom thirds of baseline levels, pooled relative risks for arsenic and lead were 1.30 (95% confidence interval 1.04 to 1.63) and 1.43 (1.16 to 1.76) for cardiovascular disease, 1.23 (1.04 to 1.45) and 1.85 (1.27 to 2.69) for coronary heart disease, and 1.15 (0.92 to 1.43) and 1.63 (1.14 to 2.34) for stroke. Relative risks for cadmium and copper were 1.33 (1.09 to 1.64) and 1.81 (1.05 to 3.11) for cardiovascular disease, 1.29 (0.98 to 1.71) and 2.22 (1.31 to 3.74) for coronary heart disease, and 1.72 (1.29 to 2.28) and 1.29 (0.77 to 2.17) for stroke. Mercury had no distinctive association with cardiovascular outcomes. There was a linear dose-response relation for arsenic, lead, and cadmium with cardiovascular disease outcomes.ConclusionExposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioural risk factors.

Study of LCAT and some biochemical parameters in cardiovascular patient

“…The results shown in Table (1) and Table (2) show a significant increase (P≤0.001) in the serum copper level of vascular patients of both sexes. This result is consistent with Chowdhury and his group 2018 [63] that copper helps increase the risk of vascular disease by promoting the LDL oxidation process, which in turn contributes to atherosclerosis, that is, its low level is positive towards the prevention of this injury. Overall, the high level of copper Has a harmful role in promoting and increasing the condition of oxidative stress by increasing the number of active oxygen in the case of free and not associated with protein or otherwise, as in this case has the ability to produce free radicals and the middle of the process of lipid peroxidation [64,65].…”

Metal/Metalloid Levels in Electronic Cigarette Liquids, Aerosols, and Human Biosamples: A Systematic Review

“…The presence of metals and metalloids (e.g., arsenic, chromium, lead, nickel) in e-cigarette aerosols is a major concern, given their serious health effects, including cancer (García-Esquinas et al 2014;Kuo et al 2017), cardiovascular disease (Chowdhury et al 2018;Moon et al 2012), renal damage (Suwazono et al 2006), and neurotoxicity (Sankhla et al 2017). Metals/metalloids may originate from the coil (Farsalinos et al 2015;Olmedo et al 2018) and from soldered joints and other parts of the device (Williams et al 2017).…”

Limb Preservation Using Edetate Disodium-based Chelation in Patients with Diabetes and Critical Limb Ischemia: An Open-label Pilot Study

“…Tellez-Plaza et al demonstrated an association of urine cadmium with PAD [4]. A meta-analysis by Chowdhury et al, encompassing over 300,000 patients, recently reported that lead and cadmium are cardiovascular risk factors with a doseresponse relationship [24]. An environment-wide association analysis by Zhuang et al, in 2018, analyzed the NHANES data for predictors of PAD [25].…”