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A Clinical Perspective on Arsenic Exposure and Development of Atherosclerotic Cardiovascular Disease

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Abstract

Cardiovascular risk has traditionally been defined by modifiable and non-modifiable risk factors, such as tobacco use, hyperlipidemia, and family history. However, chemicals and pollutants may also play a role in cardiovascular disease (CVD) risk. Arsenic is a naturally occurring element that is widely distributed in the Earth’s crust. Inorganic arsenic (iAs) has been implicated in the pathogenesis of atherosclerosis, with chronic high-dose exposure to iAs (> 100 µg/L) being linked to CVD; however, whether low-to-moderate dose exposures of iAs (< 100 µg/L) are associated with the development of CVD is unclear. Due to limitations of the existing literature, it is difficult to define a threshold for iAs toxicity. Studies demonstrate that the effect of iAs on CVD is far more complex with influences from several factors, including diet, genetics, metabolism, and traditional risk factors such as hypertension and smoking. In this article, we review the existing data of low-to-moderate dose iAs exposure and its effect on CVD, along with highlighting the potential mechanisms of action.

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Authors and Affiliations

  1. Department of Internal Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Gurleen Kaur

  2. Division of Cardiovascular Medicine, University of Maryland, Baltimore, MD, USA

    Karan P. Desai

  3. Stuyvesant High School, New York, NY, USA

    Isabella Y. Chang

  4. Division of Cardiology, New York University School of Medicine, New York, NY, USA

    Jonathan D. Newman & Sripal Bangalore

  5. Division of Nephrology, Loma Linda VA Health Care System, Loma Linda, CA, USA

    Roy O. Mathew

  6. Division of Cardiology, Department of Medicine, Albany Medical College and Albany Medical Center, Albany, NY, USA

    Ferdinand J. Venditti & Mandeep S. Sidhu

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  1. Gurleen Kaur
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  2. Karan P. Desai
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Contributions

Conception of the idea for the review: Dr. Desai, Dr. Venditti, and Dr. Sidhu.

Performed the literature search and drafted the review: Dr. Kaur, Dr. Desai, and Ms. Chang.

Critical revision of drafts: Dr. Kaur, Dr. Desai, Ms. Chang, Dr. Newman, Dr. Mathew, Dr. Bangalore, Dr. Venditti, and Dr. Sidhu.

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Correspondence to Mandeep S. Sidhu.

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Kaur, G., Desai, K.P., Chang, I.Y. et al. A Clinical Perspective on Arsenic Exposure and Development of Atherosclerotic Cardiovascular Disease. Cardiovasc Drugs Ther 37, 1167–1174 (2023). https://doi.org/10.1007/s10557-021-07313-9

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