We assessed the role of lead and cadmium as partial mediators between smoking and composite cardiovascular and cerebrovascular disease (CCVD). We also studied the association between urinary heavy metals and CCVD. Pooled data from NHANES 1999-2006 were examined. Cardiovascular and cerebrovascular disease was determined using a standardized questionnaire asking about history of stroke, angina, heart attack, coronary artery disease, and congestive heart failure. Increasing serum cadmium levels were associated with increasing prevalence of CCVD (P-trend: .03). Adjusted odds-ratio (OR) for active smokers versus never smokers was 2.09 (1.67-2.63). Adjustment for lead did not affect the OR but adjustment for cadmium significantly attenuated the OR (1.54 [1.17-2.03]). Significant association was observed between CCVD and urinary antimony, cadmium, cobalt, and tungsten. High levels of serum cadmium (>0.61 µg/L) were associated with CCVD. The relationship between smoking and CCVD was partially mediated through cadmium. Urinary antimony, cadmium, cobalt, and tungsten may be associated with CCVD.
Agency for toxic substances and disease registry.CERCLA Priority list of hazardous substances, 2005. http://www.atsdr.cdc.gov.cercla. Accessed July 25, 2010.
2.
Hoffmann D., Hoffmann I., El-Bayoumy K.The less harmful cigarette: a controversial issue. a tribute to Ernst L. Wynder. Chem Res Toxicol. 2001;14(7):767-790.
3.
Loh HSCigarette smoking and the pathogenesis of atherosclerosis-a hypothesis. Ir J Med Sci. 1973;142(4):174-178.
4.
Navas-Acien A., Selvin E., Sharrett R., Calderon-Aranda E., Silbergeld E., Guallar E.Lead, cadmium, smoking and increased risk of peripheral arterial disease. Circulation. 2004;109(25): 3196-3201.
5.
Carroll REThe relationship of cadmium in the air to cardiovascular disease death rates . JAMA. 1966;198(3):267-269.
6.
Ponteva M., Elomaa I., Bäckman H., Hansson L., Kilpiö J.Blood cadmium and plasma zinc measurements in acute myocardial infarction . Eur J Cardiol. 1979;9(5):379-391.
7.
Adamska-Dyniewska H., Bała T., Florczak H., Trojanowska B.Blood cadmium in healthy subjects and in patients with cardiovascular diseases. Cor Vasa. 1982 ;24(6):441-447.
8.
Staessen JA, Buchet JP, Ginucchio G., et al. Public health implications of environmental exposure to cadmium and lead: an overview of epidemiological studies in Belgium. Working Groups. J Cardiovasc Risk. 1996;3(1):26-41.
9.
Peters J.L., Perlstein TS, Perry MJ, McNeely E., Weuve J.Cadmium exposure in association with history of stroke and heart failure. Environ Res.2010;110(2):199-206.
10.
http://www.cdc.gov/nchs/nhanes.htm. Accessed March 2, 2010.
11.
Pirkle J.L. , Flegal KM, Bernert JT, Brody DJ, Etzel RA, Maurer KRExposure of the US population to environmental tobacco smoke: the third national health and nutrition examination survey, 1988 to 1991. JAMA. 1996;275(10):1233-1240.
12.
Levey AS, Coresh J., Balk E., et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation classification and stratification [published erratum appears in Ann Intern Med. 2003;139:605]. Ann Intern Med.2003; 39(2):920-929.
13.
Coresh J., Selvin E., Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17): 2038-2047.
14.
Selvin S., Manzi J., Stevens LA, et al. Calibration of serum creatinine in the National Health and Nutrition Examination Surveys (NHANES) 1988-1994, 1999-2004. Am J Kidney Dis.2007; 50(5):918-926.
15.
http://www.cdc.gov/niosh/topics/ABLES. Accessed November 17, 2010.
16.
http://www.osha.gov/SLTC/cadmium/index.html. Accessed November 17, 2010.
17.
Agency for toxic substances and disease registry.Toxicological profile for lead. Atlanta, GA: US Department of Health and Human Services. Public health service; 1999.
18.
Agency for toxic substances and disease registry.Toxicological profile for cadmium. Atlanta, GA: US Department of Health and Human Services. Public health service; 1999.
19.
Jarup L., Akesson A.Current status of cadmium as an environmental health problem. Toxicol Appl Pharmacol.2009;238(3):201-208.
20.
Sharrett AR , Ding J., Criqui MH, et al. Smoking, diabetes, and blood cholesterol differ in their associations with subclinical atherosclerosis: the Multiethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2006;186(2):441-447.
21.
Gordon T., Kannel WBPredisposition to atherosclerosis in the head, heart, and legs. The Framingham study. JAMA. 1972; 221(7): 661-666.
22.
Heo Y., Parsons PJ, Lawrence DALead differentially modifies cytokine production in vitro and in vivo. Toxicol Appl Pharmacol. 1996;138(1):149-157.
23.
Kaji T., Suzuki M., Yamamoto C., Mishima A., Sakamoto M., Kozuka H.Severe damage of cultured vascular endothelial cell monolayer after simultaneous exposure to cadmium and lead. Arch Environ Contam Toxicol . 1995;28(2):168-172.
24.
Stohs SJ, Bagchi D.Oxidative mechanisms in the toxicity of metal ions. Free Radic Biol Med. 1995;18(2):321-336.
25.
Vaziri ND, Ding Y., Ni Z.Compensatory up-regulation of nitric-oxide synthase isoforms in lead-induced hypertension; reversal by a superoxide dismutase-mimetic drug. J Pharmacol Exp Ther. 2001;298(2):679-685.
26.
Demontis MP , Varoni MV, Volpe AR, Emanueli C., Madeddu P.Role of nitric oxide synthase inhibition in the acute hypertensive response to intracerebroventricular cadmium. Br J Pharmacol. 1998;123(1):129-135.
27.
Prozialeck WC, Edwards JR, Nebert DW, Woods JM, Barchowsky A., Atchison WDThe vascular system as a target of metal toxicity . Toxicol Sci. 2008;102(2):207-218.
28.
Everett CJ, Frithsen ILAssociation of urinary cadmium and myocardial infarction. Environ Res. 2008;106(2):284-286.
29.
Tellez-Plaza M., Navas-Acien A., Crainiceanu CM, Guallar E.Cadmium exposure and hypertension in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Environ Health Perspect. 2008;116(1):51-56.
30.
Egwuogu H., Shendell DG, Okosun IS, Goodfellow L.The effect of urinary cadmium on cardiovascular fitness as measured by VO2 max in white, black and Mexican Americans. Environ Res.2009;109(3):292-300.
31.
Navas-Acien A. , Silbergeld EK, Sharrett R., Calderon-Aranda E., Selvin E., Guallar E.Metals in urine and peripheral arterial disease. Environ Health Perspect. 2005;113(2):164-169.
32.
Agency for toxic substances and disease registry (ATSDR).Toxicological profile for antimony. Atlanta, GA: US. Department of Health and Human Services, Public health service;1992.
33.
Agency for toxic substances and disease registry (ATSDR).Toxicological profile for cobalt. Atlanta, GA: US. Department of Health and Human Services, Public health service;2004.
34.
Agency for toxic substances and disease registry (ATSDR).Toxicological profile for tungsten. Atlanta, GA: US. Department of Health and Human Services, Public health service; 2005.
