Muhammad Isman Jusuf

Faculty of Sport and Health

Gorontalo State University
 Cerebro-cardio-vascular disease is among the
three commonest causes of deaths worldwide
and is the commonest cause of disability
 Modifiable risk factors are high blood pressure,
dyslipidemia, diabetes, smoking, alcohol
consumption, obesity, and other metabolic
syndromes
 Because of industrial development and
environmental pollution, the contribution of
environmental toxins and heavy metals to
cerebro-cardio-vascular disease warrants
thorough investigation.
 Heavy metal toxicity can be identified in
diseases that include thrombosis,
hypertension, coronary heart disease,
myocardial infarction, cardiac arrhythmias,
increased carotid intima-media thickness,
carotid artery obstruction, generalized
atherosclerosis, and cerebrovascular
accidents
 This systematic review evaluates the evidence
on the association between heavy metal
exposure and cerebro-cardio-vascular
disease in human populations.
 We reviewed all observational studies from
database searches and citations regarding
heavy metal and cerebro-cardiovascular
disease.
 The most commonly used terms for metal
pollutants, “heavy metals” or “toxic heavy
metals”, refer to specific density, atomic
weight, atomic number, or other chemical
properties
 These include lead, arsenic, mercury,
cadmium
 We will focus on these four toxic, metals that
are ranked among the top 10 on the current
Agency for Toxic Substances and Disease
Registry Priority List of Hazardous Substances
 Increased cardiovascular mortality has been
attributed to both elevated blood and bone
lead levels with stronger association shown
for bone levels
 The association of lead exposure with

hypertension is one of the best-established

cardiovascular effects of this metal
 Lead exposure has also been linked to

dyslipidemia and atherosclerosis

 Cadmium is associated with cardiovascular
and all-cause mortality
 The study reported an association of blood,

but not urine, cadmium levels with a modest

elevation of blood pressure
 Cadmium has also been associated with

Peripheral Arterial Disease in both men and

women
 The study reported an association between
high levels of mercury exposure via
freshwater fish consumption and risk of acute
myocardial infarction (AMI), all-cause, and
cardiovascular mortality
 Correlations have been shown between hair

or blood mercury and elevated Blood Pressure

 The study reported that long term exposure
to low to moderate arsenic levels is
associated with cardiovascular disease
incidence and cardiovascular mortality
 High levels of well-water arsenic exposure

are recognized as being causative in the

development of peripheral arterial disease
 Many metals have been shown to increase
lipid peroxidation.In addition, metal-related
ROS-mediated changes include microtubule
destruction, mitochondrial damage by
disruption of the membrane potential,
inhibition of ATP production, followed by
dysfunction of ion transporters such as Ca-
ATPase and Na-K-ATPase causing changes in
calcium homeostasis
 Lead has also been shown to promote
endothelial release of endothelin, to elevate
serum levels of norepinephrine, angiotensin-
converting enzyme (ACE) and thromboxane,
and to decrease production of prostacyclin
 arsenic has been linked to increased
intravascular inflammation by up-regulating
interleukin 6, tumor necrosis factor alpha,
and monocyte chemotactic protein, vascular
cell adhesion molecule and intercellular
adhesion molecule
 cadmium reaches smooth muscle cells and
accumulates there, activating smooth muscle
cell proliferation and apoptosis
 Cadmium is also associated with

perturbations in inflammation and

coagulation, including elevated blood C-
reactive protein and fibrinogen
 The overall vascular effects of mercury
include increased oxidative stress and
inflammation, reduced oxidative defense,
thrombosis, vascular smooth muscle
dysfunction, endothelial dysfunction,
dyslipidemia, and immune and mitochondrial
dysfunction
 We conclude that heavy metal pollution is
linked to cerebrocardiovascular disease.