A review of the epidemiologic literature on the role of environmental arsenic exposure and cardiovascular diseases.
Cardiovascular disease is the leading cause of mortality worldwide. Arsenic is a ubiquitous metalloid in the crust of the earth. Chronic arsenic poisoning is becoming an emerging epidemic in Asia. Epidemiological studies have shown that chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases in dose-response relationships. These cardiovascular disorders include carotid atherosclerosis detected by ultrasonography, impaired microcirculation, prolonged QT interval and increased QT dispersion in electrocardiography, and clinical outcomes such as hypertension, blackfoot disease (a unique peripheral vascular disease endemic in southwestern Taiwan), coronary artery disease and cerebral infarction. Chronic arsenic poisoning is an independent risk factor for cardiovascular disease. The adverse cardiovascular effects of long-term arsenic exposure may be persistent and/or irreversible. Arsenic-induced cardiovascular diseases in human population may result from the interaction among genetic, environment and nutritional factors. The major adverse cardiovascular effect of chronic arsenic poisoning has been established qualitatively and quantitatively in the high arsenic exposure areas, but the low-dose effect of arsenic on cardiovascular diseases remains to be explored. Cardiovascular death is the major cause of mortality worldwide, and a small increased risk may imply a large quantity of excess mortality.
Wang
Chih-Hao
CH
Department of Cardiology, Cardinal Tien Hospital and College of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Hsiao
Chuhsing Kate
CK
Chen
Chi-Ling
CL
Hsu
Lin-I
LI
Chiou
Hung-Yi
HY
Chen
Shu-Yuan
SY
Hsueh
Yu-Mei
YM
Wu
Meei-Maan
MM
Chen
Chien-Jen
CJ
D001151:Arsenic / Q000633:toxicity*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology* / Q000235:genetics; D002561:Cerebrovascular Disorders / Q000139:chemically induced / Q000453:epidemiology; D004781:Environmental Exposure; D006801:Humans; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects; D011042:Poisons / Q000633:toxicity*; D014652:Vascular Diseases / Q000139:chemically induced / Q000453:epidemiology
D011042:Poisons; D001151:Arsenic