Evidence map›Paper›PMID 40037379›Full record

SynthesisEuropean journal of preventive cardiology2025

Association of environmental metallic and metalloid contaminants with cardiovascular and all-cause mortality: an umbrella review of systematic reviews and meta-analyses.

Xinxin He, Haohang Sun, Yang Zhao, Xueru Fu, Mengdi Wang, Mengna Liu, Yijia Su, Fulan Hu, Pei Qin, Ming Zhang and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of preventive cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Tackling metals to advance cardiovascular health.European journal of preventive cardiology · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Xinxin HeDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, 518001, Peoples's Republic of China.
Haohang SunCardiovascular Department, Zhengzhou Yihe Hospital Affiliated to Henan University, Zhengzhou, Henan, 450041, People's Republic of China.
Yang ZhaoDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, 518001, Peoples's Republic of China.
Xueru FuDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, 518001, Peoples's Republic of China.
Mengdi WangCenter for Clinical Epidemiology and Evidence-Based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, Peoples's Republic of  China.
Mengna LiuCenter for Clinical Epidemiology and Evidence-Based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, Peoples's Republic of  China.
Yijia SuCenter for Clinical Epidemiology and Evidence-Based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, Peoples's Republic of  China.
Fulan HuDepartment of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China.ORCID 0000-0002-2386-1503
Pei QinCenter for Clinical Epidemiology and Evidence-Based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, Peoples's Republic of  China.ORCID 0000-0003-2303-0379
Ming ZhangDepartment of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China.
Dongsheng HuDepartment of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, 518001, Peoples's Republic of China.ORCID 0000-0002-9998-8041

Funding

Guangdong Basic and Applied Basic Research Foundation 2021A1515012503Guangdong Basic and Applied Basic Research Foundation 2022A1515010503Henan Province 232102311017Nanshan District Science and Technology Program Key Project of Shenzhen NS2022009National Natural Science Foundation of China 81973152National Natural Science Foundation of China 82073646National Natural Science Foundation of China 82103940National Natural Science Foundation of China 82273707National Natural Science Foundation of China 82304228Postdoctoral Research Foundation of China 2021M692903Shenzhen Science and Technology Program JCYJ20210324093612032Shenzhen Science and Technology Program JCYJ20220818095818040
6 · The paper itself

Abstract

aimsThe aim was to examine the relationship between exposure to environmental metallic and metalloid pollutants and cardiovascular disease (CVD) and all-cause mortality by integrating the information currently available from systematic reviews and meta-analyses. METHODS AND

resultsPubMed, Embase, and Web of Science for systematic reviews and meta-analyses were thoroughly searched up to 9 October 2024. Systematic reviews and meta-analyses of various kinds that evaluated the relationship between exposure to ambient metallic and metalloid pollutants and CVD and all-cause mortality were included. The methodological quality and the evidence quality were assessed using AMSTAR2 and GRADE, respectively. We identified 25 meta-analyses and 81 health outcomes-76 unique outcomes from observational studies and 5 unique outcomes from RCTs-from 8841 independent publications. Exposure to non-essential metallic and metalloid pollutants, including arsenic, lead, and cadmium as well as essential metallic and metalloid contaminants like copper, has been associated with an elevated risk of CVD events and CVD mortality, according to moderate-quality evidence. According to low-quality evidence, exposure to arsenic, lead, and cadmium increases the risk of CHD, while exposure to lead, cadmium, and copper is strongly associated with an increased risk of stroke and all-cause mortality. Further, zinc and selenium may be protective factors for CVD and all-cause mortality.

conclusionDespite variations in evidence gradients, environmental metallic and metalloid contaminants like arsenic, lead, cadmium, mercury, and copper are linked to CVD events and mortality, whereas zinc and selenium may offer protection. LAY SUMMARY: Non-essential environmental metallic and metalloid contaminant exposure is associated with a higher risk of CVDs and all-cause mortality, whereas essential metallic and metalloid may confer a protective benefit.Non-essential metallic and metalloid contaminants, such as arsenic, lead, and cadmium, raise the possibility of CVD events, CHD, and all-cause mortality, with lead and cadmium associated with higher risk of stroke.Essential metallic and metalloid contaminants like zinc and selenium can protect against CVD events and CHD, but too much selenium or copper may be harmful.

Indexed as

Cardiovascular DiseasesEnvironmental ExposureEnvironmental PollutantsMetalloidsMetalsCause of DeathHumansMeta-Analysis as TopicRisk AssessmentRisk FactorsSystematic Reviews as TopicEnvironmental PollutantsMetalloidsMetalsAll-cause mortalityCardiovascular diseaseCoronary heart diseaseEnvironmental metallic and metalloid contaminantsStrokeUmbrella review

Identifiers

PMID40037379

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.