摘要
Cardiovascular disease(CVD)and environmental degradation are leading global health problems of our time.Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes,particularly in populations from low-and middle-income countries,where concomitant rapid development occurs.In this review,we 1)assessed the totality,quantity,and consistency of the available epidemiological studies,linking heavy metal exposures to the risk of CVD(including stroke and coronary heart disease);2)discussed the potential biological mechanisms underlying some tantalizing observations in humans;and 3)identified gaps in our knowledge base that must be investigated in future work.An accumulating body of evidence from both experimental and obser-vational studies implicates exposure to heavy metals,in a dose-response manner,in the increased risk of CVD.The limitations of most existing studies include insufficient statistical power,lack of comprehensive assessment of exposure,and cross-sectional design.Given the widespread exposure to heavy metals,an urgent need has emerged to investigate these putative associations of environmental exposures,either independently or jointly,with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations,and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.