Critical Associations of Metal Exposure from Environmental Pollution linked to Cardiovascular Health: Study - Video

Metal exposure from environmental pollution is associated with increased calcium buildup in the coronary arteries at a level comparable to traditional risk factors like smoking and diabetes, according to a study published in the Journal of the American College of Cardiology. The findings support that metals in the body are associated with the progression of plaque buildup in the arteries and potentially provide a new strategy for managing and preventing atherosclerosis.

"Our findings highlight the importance of considering metal exposure as a significant risk factor for atherosclerosis and Cardiovascular diseases," said Katlyn E. McGraw, PhD, a postdoctoral research scientist at Columbia University Mailman School of Public Health and lead author of the study. "This could lead to new prevention and treatment strategies that target metal exposure."

"This groundbreaking study underscores the critical associations of metal exposure from environmental pollution to cardiovascular health,” said Harlan M. Krumholz, the Harold H. Hines, Jr. Professor at Yale and Editor-in-Chief of Journal of the American College of Cardiology. “It challenges us to broaden our approach to Cardiovascular disease prevention beyond traditional risk factors and to advocate for stronger environmental regulations, and it underscores the need for continued research in this critical area."

Researchers used data from the Multi-Ethnic Study of Atherosclerosis (MESA) prospective cohort, tracking 6,418 men and women aged 45-84 from diverse racial backgrounds free from clinical Cardiovascular disease, to measure urinary metal levels at the beginning of the study in 2000-2002. They examined non-essential (cadmium, tungsten, uranium) and essential (cobalt, copper, zinc) metals, both common in U.S. populations and associated with Cardiovascular disease.

Results provided evidence that metal exposure may be associated with atherosclerosis over 10 years by increasing coronary calcification.

Comparing the highest to lowest quartile of urinary cadmium, CAC levels were 51% higher at baseline and 75% higher over the 10-year period. For urinary tungsten, uranium and cobalt, the corresponding CAC levels over the 10-year period were 45%, 39%, and 47% higher, respectively. For copper and zinc, the corresponding estimates dropped from 55% to 33% and from 85% to 57%, respectively, after adjustment for clinical factors.

Non-essential and essential urinary metal levels also varied by demographic characteristics. Higher urinary metal levels were seen in older participants, Chinese participants and those with less education. Participants from Los Angeles had markedly higher urinary tungsten and uranium levels, and somewhat higher cadmium, cobalt, and copper levels.

The study's analysis also considered traditional Cardiovascular disease risk factors such as smoking, diabetes, and LDL-cholesterol levels. The associations between metals and CAC progression were comparable in magnitude to those for traditional risk factors.

“Pollution is the greatest environmental risk to cardiovascular health,” McGraw said. “Given the widespread occurrence of these metals due to industrial and agricultural activities, this study calls for heightened awareness and regulatory measures to limit exposure and protect cardiovascular health.”

Reference: McGraw, K. E., Schilling, K., Glabonjat, R. A., Galvez-Fernandez, M., Domingo-Relloso, A., Martinez-Morata, I., Jones, M. R., Nigra, A., Post, W. S., Kaufman, J., Tellez-Plaza, M., Valeri, L., Brown, E. R., Kronmal, R. A., Barr, R. G., Shea, S., Navas-Acien, A., & Sanchez, T. R. (2024). Urinary metal levels and coronary artery calcification: Longitudinal evidence in the Multi-Ethnic Study of Atherosclerosis. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2024.07.020