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Vitamins and Minerals (Poster Session)

(P30-023-25) Environmental Elements, Nutritional Minerals, and Cardiovascular Diseases

Monday, June 2, 2025
11:45 AM - 12:45 PM ET
Location: Poster Board E-18

    Presenting Author(s)

  • SL

    Simin Liu, MD, ScD

    Chair and Distinguished Professor
    University of California, Irvine, Joe C. Wen School of Population & Public Health
    Sharon, Massachusetts, United States

    • Co-Author(s)

  • BY

    Bo Yang, ScM

    Brown University
    Providence, Rhode Island, United States

  • ES

    Eduardo J. Simoes

    University of Missouri

  • TZ

    Tongzhang Zheng

    Brown University

Disclosure(s):
Simin Liu, MD, ScD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Conceptualize a biological framework in which all environmental influences are unified at the elemental levels of approximately 30 elements that make up all life on Earth. There remains much uncertainty about how specific beneficial elements and their interactions contribute to counteracting the adverse effects of toxic elements on cardiovascular disease (CVD). Thus, we investigated the impact of all identifiable elements on CVD risk in a series of systematic reviews of published studies up to December 1, 2024.

Methods: Studies reporting risk estimates with exposures to arsenic (As), lead (Pb), cadmium (Cd), mercury (Hg), copper (Cu), selenium (Se), zinc (Zn), iron (Fe), magnesium (Mg), chromium (Cr), manganese (Mn), molybdenum (Mo), vanadium (V), tungsten (W), and cobalt (Co), were included. Relative risk (RR) estimates were standardized to a common scale and pooled across studies for each metal marker using a fixed-effects or random-effects model.

Results: Of the 1,816,552 men and women from 101 studies, several metals displayed a significantly higher risk of CVD, with pooled RR (95%CI) of 1.61 (1.09–2.38) for Cd, and 1.87 (1.40-2.48) for Cu. Mg was associated with lower risk (RR 0.83 [0.74-0.94]). Pb was significantly associated with a higher risk (1.79, 1.31-2.44). Genetic instruments for Se, Mg, Cu, Pb, and Zn (using the genome-wide significance threshold of P < 5×10–8) and for Cd, Co, Cu, Cr, Hg, Mn, Mo, Ni, Pb and Zn (using P < 5×10–6) were identified in Mendelian Randomization (MR) analysis showing genetically predicted higher levels of Cu and Mg levels were associated with a lower risk, whereas genetically predicted higher levels of Zn, As and Cd were associated with an increased risk of CVD.

Conclusions: In this series of systematic reviews and meta-analyses, As, Pb, Cd, and Cu were associated with increased CVD risk, while Mg was associated with decreased risk. The MR assessment indicates potential causal links between these elements and CVD risk. Although significant heterogeneities were identified by study design, sex, and past medical history, available data supports synergistic or antagonistic effects of multiple elements and their dose-response relationship with CVD. This unifying thesis concerning CVD risk warrants further investigation in large, high quality prospective cohorts of diverse populations.

Funding Sources: R01 ES031391
R01 DK125403