Most people are exposed to low or moderate levels of lead, cadmium, and arsenic through their environment, including the air, water, soil, and food. These exposures are associated with an increased risk of coronary artery disease, peripheral artery disease, and stroke, according to a recent statement from the American Heart Association (AHA).
Exposure to contaminated metals is a part of everyday life. Lead can be found in paint in old homes (though its use was banned in the United States in 1978), tobacco products, cigarette smoke, water pipes, and contaminated foods. Cadmium can also be found in cigarette smoke, as well as in nickel cadmium batteries, plastics, ceramics and glassware, and construction products. Arsenic exposure typically happens through groundwater, which impacts drinking water, but it can also be found in rice.
The AHA statement noted that while exposure and risk occur irrespective of socioeconomic level, some people experience greater exposure to toxic metals (eg, those who live closer to major roadways, industrial sources, and hazardous waste sites, or who live in older homes).
“This is a global issue in which lower-income communities are disproportionately exposed to toxic metals through contaminated air, water, and soil,” said Ana Navas-Acien, MD, PhD, of Columbia University’s Mailman School of Public Health, in a press release. “Addressing metal exposure in these populations may provide a strategy to reduce cardiovascular disease disparities and advance environmental justice.”
Outlining the Risks
The AHA’s statement outlines global epidemiologic research confirming that lead, cadmium, and arsenic are all linked with premature death, partly due to a greater risk cardiovascular disease. That research includes:
- A 2021 AHA scientific statement that associated toxic metals with an increased risk of peripheral artery disease
- A 2018 review published in the British Medical Journal that reported higher urine levels of arsenic and higher blood levels of lead and cadmium were associated with an 85% higher risk for stroke and heart disease
- A Chinese study that found higher levels of lead in the blood were linked with carotid plaque in people with type 2 diabetes and a second study that found that cadmium and arsenic were correlated with an augmented rate of heart disease and ischemic stroke
- A general population study in Spain that found that cadmium in urine was associated with increased rates of newly diagnosed cardiovascular disease
What Can Be Done?
To mitigate some of these metal-related health risks, it is important to monitor metal levels and test for dangerous metals in individuals, the authors suggested. For example, lead levels are monitored via blood tests in children who show signs of exposure; however, there are no monitoring guidelines or established exposure limits for contaminated metals in adults, unless they are required for specific vocations. “Future research is needed to establish if such testing may be an effective strategy to identify and protect people at risk of cardiovascular disease,” the AHA said.
Gervasio A. Lamas, MD, FAHA, of Columbia University and chair of the statement’s volunteer writing group, concluded that “cardiovascular health may be improved with a multi-pronged approach that recognizes environmental cardiology and includes environmental monitoring and biomonitoring of contaminant metals; controlling for sources of exposure; and developing clinical interventions that remove metals or weaken their effects on the body.”
© 2025 Mashup Media, LLC, a Formedics Property. All Rights Reserved.