An extensive epidemiological study conducted on the Multi-Ethnic Study of Atherosclerosis (MESA) has revealed a concerning association between the presence of both non-essential and essential metals in urine and an increased risk of cardiovascular disease (CVD) and all-cause mortality. The study, spanning over 17 years, found that various individual urinary metals, including cadmium, tungsten, uranium, cobalt, copper, and zinc, were linked to higher incident events when comparing the highest to lowest quartiles.
Among the metals analyzed, cadmium and copper exhibited a positive linear dose-response relationship with both incident CVD and mortality. These findings highlight the potential predictive value of urinary metal levels in assessing the risk of CVD and mortality. The study underscores the significance of atherosclerosis as a major underlying pathway explaining the association of metals with clinical events, suggesting that subclinical associations may have clinical relevance.
The results of this study have significant implications for public health policies and regulations concerning metal exposure. Arsenic, cadmium, and lead have already been established as contaminant metals that pose a risk for CVD, with exposure to cadmium being particularly associated with adverse effects on various organs. The study also highlighted the less studied metals, uranium and tungsten, as potential risk factors for CVD due to their prevalence in common exposures like drinking water, food, air pollution, and indoor dust.
While cadmium, along with cobalt and zinc, are tightly regulated, the study emphasizes the need to investigate the sources of excess exposure to metals like tungsten and cobalt. More research is required to understand the relative contributions of drinking water, food, and air pollutants to biomarkers reflecting internal metal exposure. The investigators urge federal regulators to consider the impact of these less studied metals on human health and work towards reducing environmental exposure to them.
The relationship between urinary metal levels and cardiovascular health is a complex and multifaceted issue that warrants further investigation. The findings of this study underscore the importance of monitoring and regulating exposure to harmful metals to reduce the risk of CVD and mortality, particularly in underserved communities. By shedding light on the impact of metal exposure on cardiovascular health, this study opens the door for potential interventions aimed at reducing health disparities and improving outcomes for individuals at risk of cardiovascular disease.
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