Endocrine Disruptors and the Heart: Unraveling the Cardiovascular Impact

Endocrine disrupting chemicals (EDCs) are environmental contaminants that interfere with the hormonal system, posing significant risks to human health. Found in everyday items such as plastics, pesticides, cosmetics, and industrial materials, EDCs include both persistent chemicals, for example, dichlorodiphenyltrichloroethane (DDT), polychlorinated biphenyls (PCBs), and per- and polyfluoroalkyl substances (PFAS) and non-persistent ones, for example, bisphenol A (BPA), phthalates, and parabens. Mechanistically, EDCs mimic or block natural hormones, affecting processes such as glucose metabolism, lipid metabolism, and insulin signaling. These disruptions elevate the risk of obesity, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular diseases, especially when exposure occurs during prenatal and early life stages. The detrimental cardiovascular impact of EDCs extends beyond their diabetogenic and obesogenic effects. EDCs such as BPA and heavy metals disrupt estrogen and androgen signaling, leading to hypertension, endothelial dysfunction, and arterial stiffness. In addition, EDCs further promote oxidative stress, which contributes to atherosclerosis and cardiovascular events. EDCs significantly impact reproductive health, causing precocious puberty, infertility, polycystic ovarian syndrome, endometriosis, and uterine fibroids in females and precocious puberty, delayed puberty, and infertility in males. The health ramifications of EDCs extend beyond the individual and can affect ensuing generations. EDCs cause epigenetic changes that can be passed down to future generations, compounding long-term impact on quality of life and healthcare spending. Intrauterine EDC exposure is associated with profound impact on fetal growth, potentially leading to low birth weight and intrauterine growth restriction, which predispose these individuals to life-long metabolic and cardiovascular challenges. Mitigation of EDC exposure requires a comprehensive prevention strategy to minimize the widespread health impacts, starting from the individual and the family unit. These include making simple swaps in daily life such as minimizing use of plastic, processed food items, scrutinizing cosmetics, and paints for possible presence of EDCs and avoiding exposure to direct and second-hand smoking. However, broader regulatory actions need to be initiated on a global level to implement stricter safety standards, minimize production of EDCs and their entry into the ecosystem and exploring safer alternatives.