ArticleInternational journal of epidemiology2017
Declining exposures to lead and cadmium contribute to explaining the reduction of cardiovascular mortality in the US population, 1988-2004.
Article in International journal of epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Pooled it
- The impact of clinical and population strategies on coronary heart disease mortality: an assessment of Rose's big idea.BMC public health · 2022Pooled it
- Article
- Sex-Specific Associations Between Cadmium Exposure and Mortality Risk in Cardiovascular Disease Patients: A Cohort Study Integrating Molecular Mechanisms of Myocardial Dysfunction.Cardiovascular toxicology · 2026Article
- The role of coronary artery calcification in metal-related cardiovascular disease.Environment international · 2026Article
- Tackling metals to advance cardiovascular health.European journal of preventive cardiology · 2025Article
- The association between whole-blood lead concentration and all-cause or cardiovascular disease mortality in hypertensive patients.Scientific reports · 2025Article
- Associations Between Blood Heavy Metal Concentrations and Hypertensive Disorders of Pregnancy in the Japan Environment and Children's Study.Journal of the American Heart Association · 2025Article
- Bottlenecks in advancing and applying multiomic data integration-common data resources as rate-limiting drivers-the high-impact use case of atherosclerotic cardiovascular disease.Briefings in bioinformatics · 2025Review
- The burden and trend prediction of ischemic heart disease associated with lead exposure: Insights from the Global Burden of Disease study 2021.Environmental health : a global access science source · 2025Article
- Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis.Journal of the American College of Cardiology · 2024Article
- Elemental Risk: Role of Metals in Cardiovascular Disease Risk.Journal of the American College of Cardiology · 2024Article
- Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA).Circulation · 2024Article
- Portable x-ray fluorescence for bone lead measurement: Current approaches and future directions.Current environmental health reports · 2024Review
- Environmental Pollution and Cardiovascular Disease: Part 2 of 2: Soil, Water, and Other Forms of Pollution.JACC. Advances · 2024Review
- The Contribution of Declines in Blood Lead Levels to Reductions in Blood Pressure Levels: Longitudinal Evidence in the Strong Heart Family Study.Journal of the American Heart Association · 2024Article
- The association between blood metals and cardiovascular diseases: findings from National Health and Nutrition Examination Survey 2011-2020.Frontiers in cardiovascular medicine · 2024Article
- Cardiovascular disease risk: it is complicated, but race and ethnicity are key, a Bayesian network analysis.Frontiers in public health · 2024Article
- Urinary Metal Levels and Coronary Artery Calcification: Longitudinal Evidence in the Multi-Ethnic Study of Atherosclerosis (MESA).medRxiv : the preprint server for health sciences · 2023Article
- Blood and Urinary Metal Levels among Exclusive Marijuana Users in NHANES (2005-2018).Environmental health perspectives · 2023Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
Abstract
Background: Lead and cadmium exposures have markedly declined in the USA following the implementation of large-scale public health policies and could have contributed to the unexplained decline in cardiovascular mortality in US adults. We evaluated the potential contribution of lead and cadmium exposure reductions to explain decreasing cardiovascular mortality trends occurring in the USA from 1988-94 to 1999-2004. Methods: Prospective study in 15 421 adults ≥40 years old who had participated in the National Health and Nutrition Examination Survey 1988-94 or 1999-2004. We estimated the amount of change in cardiovascular mortality over time that can be independently attributed to the intermediate pathway of changes in blood lead and urine cadmium concentrations. Results: There was a 42.0% decrease in blood lead and a 31.0% decrease in urine cadmium concentrations. The cardiovascular mortality rate ratio [95% confidence intervals (CIs)] associated with a doubling of metal levels was 1.19 (1.07, 1.31) for blood lead and 1.20 (1.09, 1.32) for urine cadmium. The absolute reduction in cardiovascular deaths comparing 1999-2004 to 1988-94 was 230.7 deaths/100 000 person-years, in models adjusted for traditional cardiovascular risk factors. Among these avoided deaths, 52.0 (95% CI 8.4, 96.7) and 19.4 (4.3, 36.4) deaths/100 000 person-years were attributable to changes in lead and cadmium, respectively. Conclusions: Environmental declines in lead and cadmium exposures were associated with reductions in cardiovascular mortality in US adults. Given the fact that lead and cadmium remain associated with cardiovascular disease at relatively low levels of exposure, prevention strategies that further minimize exposure to lead and cadmium may be needed.
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Registered trials
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