OLDER ADULTS WITH HIGHER levels of certain environmental pollutants are more likely than those with lower levels to have atherosclerotic plaques, researchers from Sweden have found. Asetofchemicalsknownaspersistent organicpollutantsare leachedfromlandfills, releasedduringmanufacturingand recyclingprocesses,andusedinpesticide applications. Once in the environment, thesechemicalsbioaccumulate—that is, they become more concentrated as they move up the food chain. Such pollutants can disperse widely from their original point of entry into the environment. Because of this, most humans are exposed to them to some degree, most often through the consumption of animal products. “In Sweden and in many countries in the world, many of these substances are forbidden today, but since they are so long-lived, they’re still out there in our environment,” said Monica Lind, PhD, associate professor of occupational and environmental medicine in the department of medicine at Uppsala University in Sweden. “We ingest these environmental toxicants with the food we eat, and since they are stored in our bodies, the levels grow higher the older we get.” Recently, data have emerged suggesting that individuals who have higher levels of these chemicals circulating in their blood are more likely to have cardiovascular risk factors, including hypertension, obesity, the metabolic syndrome, and diabetes. An association has also been found between myocardial infarction and higher levels of these chemicals in an individual’s blood. To further probe the relationship of these chemicals with cardiovascular disease, scientists from 2 Swedish universities assessed the presence of persistent organic pollutants and artery plaques in 1016 individuals, who participated in the Investigation of Vasculature in Uppsala Seniors Study (Lind PM et al. Environ Health Perspect. doi: 10.1289/ehp.1103563 [published online ahead of print October 11, 2011]). All participants were 70 years old and residents of Uppsala. Ultrasound was used to assess the presence of atherosclerosis, and blood samples from participants were tested for the presence of 16 polychlorinated biphenyls (PCBs), 5 pesticides, 1 dioxin, and a pollutant called BDE47. The investigators found that 7 of the PCBs were associated with how many of an individual’s arteries had plaques, even after the researchers adjusted for multiple cardiovascular risk factors. They also found that 3 highly chlorinated PCBs were associated with increased echogenicity of the intimamedia complex in the carotid artery, which has been linked to cardiovascular disease–related death. The authors concluded that their findings suggest that persistent organic pollutants may have vascular effects that are separate from traditional cardiovascular disease risk factors. The team argues that their results, as well as those of other studies, suggest that these pollutants may have direct effects on the body’s vasculature. The investigators also proposed various mechanisms by which pollutants might contribute to cardiovascular disease. For example, they noted evidence that pollutants may impair DNA repair and cell cycling in vascular smooth muscle cells and may contribute to oxidative stress. Additionally, they pointed to potential effects on sex-hormone receptors. Such effects may be important because of the role such hormones play in cardiovascular disease. news@JAMA From JAMA’s Daily News Site