Environmental heavy metals and cardiovascular diseases: Status and future direction

Ai Min Yang, Kenneth Lo, Tong Zhang Zheng, Jing Li Yang, Ya Na Bai, Ying Qing Feng, Ning Cheng, Si Min Liu

Research output: Journal article publicationReview articleAcademic researchpeer-review

88 Citations (Scopus)


Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and observational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.

Original languageEnglish
Pages (from-to)251-259
Number of pages9
JournalInflammation and cardiovascular diseases
Issue number4
Publication statusPublished - Dec 2020
Externally publishedYes


  • Cardiovascular disease
  • Coronary heart disease
  • Heavy metal
  • Hypertension
  • Stroke

ASJC Scopus subject areas

  • General Medicine


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