Abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) is a preventable type of disease, thus, specifying factors that increase the occurrence of this type of disease is needed. Heavy metals such as cadmium (Cd), lead (Pb), and mercury (Hg) have been suggested as possible factors influencing the development of cardiovascular disease. We aimed to link blood heavy metal levels (Cd, Pb, Hg) with 10-year ASCVD risk scores. Methods: A population of 993 men and 1431 women who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) were included. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) pooled cohort equations risk prediction model and Korean Risk Prediction Model (KRPM) were used as means for risk prediction. Following multivariate adjustment; blood Cd; Pb; and Hg levels were divided into quartiles for analysis using linear trends estimation and multiple regression models. Results: There was an overall positive trend between blood Cd, Pb, and Hg levels and 10-year ASCVD risk scores; KRPM risk score increasing by quartile for blood Cd (men p < 0.0001, women p = 0.0024), Pb (men p = 0.0097, women p = 0.0330), Hg (men p = 0.0096, women p = 0.0030) rates and pooled cohort equations risk score increasing by quartile for Cd (men p < 0.0001, women p = 0.0034) and Hg (men p = 0.0099, women p = 0.0010) with linear trends. Urban population showed a stronger relationship between blood Cd, Pb, and Hg levels and 10-year ASCVD risk score especially among men with multiple regression analysis. Conclusion: Blood Cd, Pb, and Hg levels are associated with ASCVD risk. Thus, they should be considered while developing preventive measures for ASCVD.
Highlights
Atherosclerotic cardiovascular disease (ASCVD), which includes nonfatal myocardial infarction, coronary heart disease (CHD) death, and fatal or nonfatal stroke [1], takes up a large proportion of healthcare budgets worldwide [2,3]
General characteristics of the study population are shown in Table 1; the relationships between the Korean Risk Prediction Model (KRPM) 10-year ASCVD risk score and variables including blood heavy metal levels (Cd, Pb, Hg), age, income status, job type, area of living, sleep duration, and physical activity type are shown stratified according to sex
The results of this study support this concept by indicating a positive overall trend between blood heavy metal levels (Cd, Pb, Hg) and 10-year ASCVD risk score in the Korean population when adjusted for age, income status, job type, area of living, sleep duration, and physical activity
Summary
Atherosclerotic cardiovascular disease (ASCVD), which includes nonfatal myocardial infarction, coronary heart disease (CHD) death, and fatal or nonfatal stroke [1], takes up a large proportion of healthcare budgets worldwide [2,3]. In addition to the extensive healthcare expenditures incurred, it is one of the leading causes of death [2,3]. This trend of severity is true for the South Korean population, where the number of cardiovascular disease patients is high, with one in five deaths. Atherosclerotic cardiovascular disease (ASCVD) is a preventable type of disease, specifying factors that increase the occurrence of this type of disease is needed Heavy metals such as cadmium (Cd), lead (Pb), and mercury (Hg) have been suggested as possible factors influencing the development of cardiovascular disease. Following multivariate adjustment; blood Cd; Pb; and Hg levels were divided into quartiles for analysis using linear trends estimation and multiple regression models
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