Association Between Arsenic Exposure and Cardiovascular Disease

Arsenic is a ubiquitously dispersed metalloid that has been implicated as the cause of various adverse health effects. Human exposure to arsenic primarily occurs through contaminated drinking water and dietary intake of rice and grains, posing a great public health risk to millions of people worldwide. High levels of arsenic have been positively associated with incident cardiovascular disease (CVD). In the last decade, a growing body of evidence has established a role for low-to-moderate arsenic exposure in CVD risk as well. The molecular mechanism of action by which arsenic induces cardiovascular toxicity is not completely understood, but epigenetic changes, increased platelet aggregation, and increased oxidative stress have all been implicated. Presently, there is a substantial amount of retrospective and prospective cohort studies supporting the role of arsenic in CVD, although randomized controlled trials have yet to be conducted. In this review, we have sought to summarize the existing high-quality evidence elucidating arsenic's role in CVD development and to evaluate the need for future research.