Research has found that environmental exposure to low levels of the toxic metals arsenic, cadmium and titanium appears to increase the risk of plaque buildup in the arteries in the neck, heart and legs.
The study was published in the Journal of Atherosclerosis, Thrombosis and Vascular Biology.
Traces of metals may enter the body through contaminated soil that seeps into food, through drinking water, air pollutants, or tobacco smoke. There is strong evidence that toxic metals, such as arsenic and cadmium, are cardiovascular risk factors. Arsenic and cadmium are often found in tobacco and food, while arsenic is also found in water. Titanium exposure is primarily derived from dental implants, orthopedics, screws, pacemaker casings, cosmetic products, and some foods.
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“Metals are ubiquitous in the environment, and people are chronically exposed to low levels of the metal,” said study lead author Maria Grau Perez, M.D., from the Institute of Biomedical Research at the Hospital de Valencia Enclave in Valencia. Spain, and a PhD candidate in the Department of Preventive Medicine, Public Health and Microbiology at the Autonomous University of Madrid, Spain.
“According to the World Health Organization, 31 percent of the global cardiovascular disease burden could be avoided if we could eliminate environmental pollutants,” she added.
Atherosclerosis develops when fatty deposits or plaques build up in the arteries, causing them to narrow, weaken, and stiffen. Depending on which arteries are affected, it can lead to heart attack, stroke, angina, peripheral artery disease, or kidney disease.
Previous research on the effect of metal exposure on atherosclerosis has traditionally focused on the carotid arteries, the major arteries in the neck. This study focused on subclinical atherosclerosis – before symptoms appeared – and examined the effect of metal exposure on the carotid, femoral and coronary arteries. Previous research suggested that imaging the femoral artery, the main artery that supplies blood to the lower body, may lead to early detection of atherosclerosis.
Researchers evaluated 1,873 adults (97 percent of men) in the Aragon Worker Health Study. Study participants worked in a car assembly plant in Spain and ranged in age from 40 to 55. The researchers measured participants’ environmental exposures to nine toxic metals — arsenic, barium, uranium, cadmium, chromium, antimony, titanium, vanadium and tungsten — and correlates exposure to the presence of subclinical atherosclerosis in the carotid, femoral, and coronary regions. The study explored the potential role of individual metals and mineral mixtures in the development of atherosclerosis.
During the participants’ annual occupational health visits between 2011 and 2014, each participant’s socioeconomic and health information was recorded, including education level, smoking status, and medication use. Each person in the study underwent a medical exam to measure their body mass index, blood pressure, blood sugar levels, cholesterol levels, triglyceride levels, and more. Urine samples were collected to assess metal exposure from air, water, and food. The researchers performed ultrasounds of the carotid and femoral arteries, as well as tests to measure coronary calcium.
The analysis found:
1. Older study participants had higher levels of most minerals measured in their urine.
2. The few study participants had higher mineral levels than the men when levels were measured in urine.
3. Adults who had ever smoked showed higher levels of arsenic, cadmium, chromium and titanium than people who had never smoked.
4. High levels of arsenic, cadmium, titanium and potentially antimony have been associated with a higher likelihood of developing subclinical atherosclerosis.
5. Arsenic and cadmium appear to be closely related to increased levels of plaque in the carotid arteries. Cadmium and titanium are of greater concern to the femoral arteries; Titanium, and possibly cadmium and antimony, are of most concern to coronary arteries.
6. Arsenic may be more toxic to arteries when combined with cadmium and titanium.
“This study supports that exposure to toxic metals in the environment, even at low exposure levels, is toxic to cardiovascular health,” said study co-author Maria Telles-Plaza, MD, a senior scientist at the National Center for Epidemiology. and the Salud Carlos III Institute in Madrid, Spain.
“The levels of metals in our study population were generally lower compared to other published studies. Metals, particularly arsenic, cadmium and titanium, are likely to be relevant risk factors for atherosclerosis, even at the lowest levels of exposure and among middle-aged working individuals.”
The study included a very specific population of men predominantly in one region of Spain, so the results may not be fully extrapolated to women or other populations worldwide. More research is needed to understand the mechanisms involved in the development of atherosclerosis based on mineral binding.
“Current global environmental, occupational and food safety standards for cadmium, arsenic and other metals may be insufficient to protect the population from the adverse health effects associated with the metals,” Telles Plaza said.
It concluded, “Prevention and mitigation of metal exposure has the potential to significantly improve the way we prevent and treat cardiovascular disease.”
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