Metal pollutants and cardiovascular disease: mechanisms and consequences of exposure

Am Heart J. 2014 Dec;168(6):812-22. doi: 10.1016/j.ahj.2014.07.007. Epub 2014 Jul 22.


Introduction: There is epidemiological evidence that metal contaminants may play a role in the development of atherosclerosis and its complications. Moreover, a recent clinical trial of a metal chelator had a surprisingly positive result in reducing cardiovascular events in a secondary prevention population, strengthening the link between metal exposure and cardiovascular disease (CVD). This is, therefore, an opportune moment to review evidence that exposure to metal pollutants, such as arsenic, lead, cadmium, and mercury, is a significant risk factor for CVD.

Methods: We reviewed the English-speaking medical literature to assess and present the epidemiological evidence that 4 metals having no role in the human body (xenobiotic), mercury, lead, cadmium, and arsenic, have epidemiologic and mechanistic links to atherosclerosis and CVD. Moreover, we briefly review how the results of the Trial to Assess Chelation Therapy (TACT) strengthen the link between atherosclerosis and xenobiotic metal contamination in humans.

Conclusions: There is strong evidence that xenobiotic metal contamination is linked to atherosclerotic disease and is a modifiable risk factor.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Arsenic / adverse effects
  • Cadmium / adverse effects
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / therapy
  • Chelation Therapy / methods*
  • Clinical Trials as Topic
  • Environmental Exposure* / adverse effects
  • Environmental Exposure* / analysis
  • Environmental Pollutants / adverse effects*
  • Humans
  • Lead / adverse effects
  • Mercury / adverse effects
  • Metals / adverse effects*
  • Risk Factors
  • Xenobiotics / adverse effects


  • Environmental Pollutants
  • Metals
  • Xenobiotics
  • Cadmium
  • Lead
  • Mercury
  • Arsenic