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Meta-Analysis
. 2013 Oct;15(10):356.
doi: 10.1007/s11883-013-0356-2.

Cadmium exposure and clinical cardiovascular disease: a systematic review

Maria Tellez-Plaza  1 , Miranda R Jones, Alejandro Dominguez-Lucas, Eliseo Guallar, Ana Navas-Acien
Affiliations
Meta-Analysis

Cadmium exposure and clinical cardiovascular disease: a systematic review

Maria Tellez-Plaza et al. Curr Atheroscler Rep. 2013 Oct.

Abstract

Mounting evidence supports that cadmium, a toxic metal found in tobacco, air and food, is a cardiovascular risk factor. Our objective was to conduct a systematic review of epidemiologic studies evaluating the association between cadmium exposure and cardiovascular disease. Twelve studies were identified. Overall, the pooled relative risks (95% confidence interval) for cardiovascular disease, coronary heart disease, stroke, and peripheral arterial disease were: 1.36 (95% CI: 1.11, 1.66), 1.30 (95% CI: 1.12, 1.52), 1.18 (95% CI: 0.86, 1.59), and 1.49 (95% CI: 1.15, 1.92), respectively. The pooled relative risks for cardiovascular disease in men, women and never smokers were 1.29 (1.12, 1.48), 1.20 (0.92, 1.56) and 1.27 (0.97, 1.67), respectively. Together with experimental evidence, our review supports the association between cadmium exposure and cardiovascular disease, especially for coronary heart disease. The number of studies with stroke, heart failure (HF) and peripheral arterial disease (PAD) endpoints was small. More studies, especially studies evaluating incident endpoints, are needed.

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Conflict of interest statement

Conflict of Interest:

Maria Tellez-Plaza, Miranda R Jones, Alejandro Dominguez-Lucas, Eliseo Guallarm and Ana Navas-Acien declare that they have no conflicto of interest.

Figures

Figure 1
Figure 1
Summary of inclusion and exclusion criteria used in this systematic review of studies investigating the association between cadmium and clinical cardiovascular disease, April 15th 2013. *12 references correspond to 7 unique study populations: Everett et al. (2008) [58] and Menke et al. 2009 [27] examined NHANES III subjects but assessed different cardiovascular endpoints; Peters et al. 2010 [60•], Tellez-Plaza et al 2010 [62•], Agarwal et al. 2011 [59] and Tellez-Plaza et al. 2012 [28••] examined NHANES 1999+ subjects but assessed different cardiovascular endpoints. Tellez-Plaza et al. 2013 [29••] and Tellez-Plaza et al. Submitted [31••] examined Strong Heart Study participants but assessed different incident cardiovascular disease endpoints.
Figure 2
Figure 2
Relative risks for cardiovascular disease endpoints per change in cadmium levels. The area of each black square (individual study) is proportional to the inverse of the variance of the estimated log relative risk. Horizontal lines represent 95 % confidence intervals. CI, confidence interval; CVD, cardiovascular; CHD, coronary heart disease; HF, heart failure; PAD, peripheral arterial disease; RR, relative risk.
See this image and copyright information in PMC

References

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