ArticleJournal of the American Heart Association2023
Contaminant Metals as Cardiovascular Risk Factors: A Scientific Statement From the American Heart Association.
Article in Journal of the American Heart Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
121 citing papers in PubMed, 3 syntheses or guidelines pooled it, 178 citations in OpenAlex.
- Airborne contaminant exposure and bone development: a systematic review and meta-analysis.Toxicological sciences : an official journal of the Society of Toxicology · 2026Pooled it
- Toxic heavy metal exposure and heart health: a systematic review and meta-analysis of 324,331 patients.BMC cardiovascular disorders · 2025Pooled it
- Mortality and hospitalization in contaminated sites with petrochemical and steel plants: a meta-regression ecological study.BMC public health · 2025Pooled it
- Metabolic Signature of Arsenic Exposure and Metabolism: The Folic Acid and Creatine Trial.Environmental science & technology · 2025Trial
- Baseline characteristics including blood and urine metal levels in the Trial to Assess Chelation Therapy 2 (TACT2).American heart journal · 2024Trial
- Impact of environmental heavy metal exposure on cardiovascular disease mortality.American journal of preventive cardiology · 2026Article
- NHANES and the rise of environmental cardiology: Metals, mortality, and the maturation of preventive evidence.American journal of preventive cardiology · 2026Article
- Environmental pollution, apolipoprotein A-1 autoantibodies and cardiovascular risk: evidence from a geospatial cross-sectional study.Atherosclerosis plus · 2026Article
- Article
- The environmental exposome in heart failure risk and progression.Nature reviews. Cardiology · 2026Review
- Risk factors associated with urinary metal concentrations in middle-aged and older Caribbean adults: the Tobago Health Study.Journal of exposure science & environmental epidemiology · 2026Article
- Changing Trends in Cardiovascular Disease Burden in North Africa and the Middle East, 1990-2023: A Joinpoint Analysis of GBD 2023 Data.Journal of clinical medicine · 2026Article
- Interpretable Machine Learning in Heavy Metal-Associated Cardiovascular and Metabolic Disease: A Review of Current Methodologies, Toxicological Insights, and Clinical Implications.Cardiovascular toxicology · 2026Review
- Urinary metal exposure, systemic inflammation, and advanced cardiovascular-kidney-metabolic syndrome risk in US adults.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Article
- Circulating multiple metals and mortality after myocardial infarction: incremental value beyond GRACE.American journal of preventive cardiology · 2026Article
- Micro- and Nanoplastics as Potential Drivers of Dilated Cardiomyopathy.Life (Basel, Switzerland) · 2026Review
- Environmental Exposures and Atherosclerotic Risk Factors in Vulnerable Youth: The Example of American Indian/Alaska Native Populations.Current atherosclerosis reports · 2026Review
- Ischemic heart disease burden and healthcare system readiness across sub-Saharan Africa.Nature cardiovascular research · 2026Review
- Genetic Polymorphisms as Modifiers of Health Risks from Exposure to Toxic Elements: A Traditional Literature Review.Toxics · 2026Review
- Article
61 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Exposure to environmental pollutants is linked to increased risk of cardiovascular disease. Beyond the extensive evidence for particulate air pollution, accumulating evidence supports that exposure to nonessential metals such as lead, cadmium, and arsenic is a significant contributor to cardiovascular disease worldwide. Humans are exposed to metals through air, water, soil, and food and extensive industrial and public use. Contaminant metals interfere with critical intracellular reactions and functions leading to oxidative stress and chronic inflammation that result in endothelial dysfunction, hypertension, epigenetic dysregulation, dyslipidemia, and changes in myocardial excitation and contractile function. Lead, cadmium, and arsenic have been linked to subclinical atherosclerosis, coronary artery stenosis, and calcification as well as to increased risk of ischemic heart disease and stroke, left ventricular hypertrophy and heart failure, and peripheral artery disease. Epidemiological studies show that exposure to lead, cadmium, or arsenic is associated with cardiovascular death mostly attributable to ischemic heart disease. Public health measures reducing metal exposure are associated with reductions in cardiovascular disease death. Populations of color and low socioeconomic means are more commonly exposed to metals and therefore at greater risk of metal-induced cardiovascular disease. Together with strengthening public health measures to prevent metal exposures, development of more sensitive and selective measurement modalities, clinical monitoring of metal exposures, and the development of metal chelation therapies could further diminish the burden of cardiovascular disease attributable to metal exposure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.