Environmental pollution from metals is increasingly recognized as a significant factor contributing to coronary artery calcification, a condition as detrimental as traditional cardiovascular risk factors such as smoking and diabetes. A study published in the Journal of the American College of Cardiology (JACC) underscores this correlation, suggesting that metals in the body play a role in the progression of arterial plaque buildup, offering a new perspective on managing and preventing atherosclerosis. Dr Katlyn E. McGraw, the lead researcher and a postdoctoral scientist at Columbia University’s Mailman School of Public Health emphasizes the need to consider metal exposure as a crucial cardiovascular risk factor, hinting at potential new prevention and treatment strategies for mitigating metal exposure.
Atherosclerosis, the underlying cause of most cardiovascular diseases (CVD), involves the narrowing and hardening of arteries due to plaque buildup, which can impede blood flow and increase the risk of clots, leading to heart attacks, strokes, and peripheral artery disease (PAD). The study introduces a significant advancement in the non-invasive measurement of coronary artery calcium (CAC), which helps predict future cardiac events. Harlan M. Krumholz, Editor-in-Chief of JACC and a noted professor at Yale highlights the research’s impact on broadening the approach to CVD prevention. He advocated for more stringent environmental regulations and continued research into the effects of metal exposure on cardiovascular health.
The researchers utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA), examining participants free from clinical CVD across various demographics. They measured levels of essential (cobalt, copper, zinc) and non-essential (cadmium, tungsten, uranium) metals, frequently used in agriculture, battery manufacturing, and mining, and often released into the environment. Notably, tobacco smoke is a primary source of cadmium. The study revealed higher urinary metal levels were associated with increased coronary calcification over a decade, with powerful effects observed for cadmium, tungsten, and uranium.
In addition to environmental sources, the study found that urinary metal levels varied significantly with demographic factors such as age, ethnicity, and education. Participants from urban areas like Los Angeles exhibited exceptionally high levels of certain metals, suggesting regional disparities in metal exposure. Despite accounting for traditional CVD risk factors like smoking, diabetes, and LDL-cholesterol levels, the relationship between metal exposure and CAC progression appeared comparably significant.
Dr. McGraw calls for heightened awareness and regulatory actions to limit metal exposure and protect cardiovascular health, considering these metals’ widespread industrial and agricultural use. The study’s limitations, including the lack of direct plaque transition measures and the potential for variability in exposure sources, underscore the complexity of assessing environmental impacts on health. Nonetheless, the findings advocate for a more inclusive cardiovascular prevention approach incorporating ecological risk factors.
In an accompanying editorial, Dr. Sadeer Al-Kindi of the Houston Methodist DeBakey Heart and Vascular Center comments on the study’s public health implications, emphasizing the importance of addressing environmental factors in cardiovascular disease prevention. This research demonstrates that the emerging field of environmental cardiovascular medicine offers new strategies for reducing the global burden of cardiovascular disease and addressing health disparities, marking a significant step forward in both public health and clinical practice.
More information: Katlyn E. McGraw et al, Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis, Journal of the American College of Cardiology. DOI: 10.1016/j.jacc.2024.07.020
Journal information: Journal of the American College of Cardiology Provided by American College of Cardiology
