Impact of environmental heavy metal exposure on cardiovascular disease mortality.

Background: Cardiovascular disease (CVD) is the primary cause of mortality worldwide, and heavy metal exposure, including lead (Pb), cadmium (Cd), and mercury (Hg), significantly impacts this global burden of CVD. Heavy metal-related cardiovascular toxicity results from their ability to induce oxidative stress, inflammation, endothelial dysfunction, and dysregulation of lipid metabolism. We aimed to investigate the association between blood concentrations of Pb, Cd, and Hg and cardiovascular mortality in a representative U.S. adult population. Method: Using the 1999-2018 National Health and Nutrition Examination Survey (NHANES) data, we examined the association of blood Pb, Cd, and Hg levels with CVD mortality. Pb, Cd, and Hg levels were transformed into quartiles. Metal levels were categorized into quartiles, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs), adjusting for demographic, clinical, and lifestyle covariates. Results: We included 55,081 participants between 1999 and 2018, of whom 4.5 % ( Conclusions: In this nationally representative cohort, blood lead and cadmium were positively associated with cardiovascular mortality, whereas mercury showed an inverse association. These findings highlight the need for continued monitoring of environmental metal exposures and their potential cardiovascular implications.