Microplastics and nanoplastics: emerging threats to cardiovascular health - a comprehensive review.

Background: Global plastic production surged to 400.3 million metric tons in 2022, contributing significantly to environmental pollution. Projections estimate that 13.2 billion tons of plastic waste will be present in ecosystems by 2050. This increase in plastic production has led to substantial human exposure to microplastics (MPs) and nanoplastics (NPs). While their environmental and general health impacts are well-documented, the specific effects on cardiovascular health remain underexplored. Objectives: This review aims to examine the presence of MPs and NPs in the environment, their routes of human exposure, and their toxicological implications for the cardiovascular system (CVS), focusing on oxidative stress, apoptosis, cardiac fibrosis, and major adverse cardiovascular events (MACE). Methods: A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar. Relevant studies from the past 10 years were selected based on keywords like "microplastics," "nanoplastics," and "cardiovascular health." Results: MPs and NPs are found in air, water, and food, entering the human body primarily through inhalation, ingestion, and dermal contact. These particles induce oxidative stress, mitochondrial dysfunction, and apoptosis, which impair cardiovascular health. MPs have been detected in arterial tissues, particularly in atherosclerotic plaques, correlating with increased MACE risk. MP exposure is linked to VC, reduced vessel flexibility, and increased thrombosis severity. Additionally, MPs contribute to inflammation and lipid metabolism disruption, which further exacerbate heart disease. Conclusion: The evidence suggests a concerning link between plastic exposure and cardiovascular health, highlighting the urgent need for further research to understand the long-term effects of MPs and NPs on CVSs.