London: Exposure to arsenic, lead, copper, and cadmium may significantly increase the risk of cardiovascular disease, a study has found.


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An international team, led by Rajiv Chowdhury from the University of Cambridge in the UK, reviewed the results of studies that had looked at the association of environmental toxic metals with coronary heart disease, stroke, and composite cardiovascular disease.


They identified 37 separate studies published before December 2017 involving almost 350,000 participants, according to the study published in The BMJ journal. A total of 13,033 coronary heart disease, 4,205 strokes, and 15,274 cardiovascular outcomes were reported across the studies.


Exposure to arsenic was found to be significantly associated with a 23 percent greater relative risk of coronary heart disease and a 30 percent greater relative risk of composite cardiovascular disease. However, there was no evidence of an association with risk of stroke.


Exposure to cadmium and copper was also associated with increased relative risks of coronary heart disease and cardiovascular disease, researchers said.


Lead and cadmium were associated with an increased relative risk of stroke (63 percent and 72 percent respectively), they said. In contrast, mercury was not found to be associated with cardiovascular risk.


The researchers noted that their review was solely based on observational data, which might be affected by unmeasured factors, making it difficult to draw firm conclusions about cause and effect.


The findings "reinforce the importance of environmental toxic metals in enhancing global cardiovascular risk, beyond the roles of conventional behavioral risk factors, such as smoking, poor diet, and inactivity," researchers said.


The study highlights the potential need for additional worldwide efforts and strategies "to reduce human exposures even in settings where there is a relatively lower average level of exposure," they said.