Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Mar 15:345:123462.
doi: 10.1016/j.envpol.2024.123462. Epub 2024 Jan 29.

Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis

Pietro Verzelloni  1 , Teresa Urbano  1 , Lauren A Wise  2 , Marco Vinceti  3 , Tommaso Filippini  4
Affiliations
Free article
Meta-Analysis

Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis

Pietro Verzelloni et al. Environ Pollut. .
Free article

Abstract

Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.

Keywords: Cadmium; Cadmium biomarkers; Cardiovascular disease; Coronary heart disease; Heart failure; Stroke.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interestsThe authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Lauren Wise receives in-kind donations from Kindara.com (fertility apps) and Swiss Precision Diagnostics (home pregnancy tests). She also serves as consultant for Gates Foundation and AbbVie, Inc. All of these relationships are for work unrelated to this manuscript. All other authors have nothing to disclosure.

LinkOut - more resources