Association between cadmium exposure and the risk of cardiovascular outcomes: a meta-analysis

Abstract The association between Cadmium (Cd) exposure and the risk of cardiovascular outcomes is still inconclusive. This meta-analysis was performed based on PECO questions (P = general population; E = Q1 Cd levels in the specimen; C = Cd levels exceeding Q1; O = cardiovascular outcomes). 1231 articles were retrieved by using search terms of cadmium and cardiovascular outcomes in PubMed, Cochrane, and Web of Science. 21 articles were included in this meta-analysis according to the PRISMA statement. Begg’s tests were used to evaluate publication bias, and there was no publication bias in studies of Cd on acute myocardial infarction (AMI) (p = .85), cardiovascular disease (CVD) (p = .05), heart disease (HD) (p = .57) and stroke (p = .14). Cd exposure increased the risk of cardiovascular outcomes including CVD (RR = 1.36, 95% Cl: 1.22–1.50), HD (RR = 1.73, 95% Cl: 1.39–2.08) and stroke (RR = 1.28, 95% Cl: 1.10–1.46). This meta-analysis indicated that Cd exposure might correlate with the occurrence of cardiovascular outcomes positively. Therefore, reducing Cd emissions to the environment or reducing the environmental intake of Cd is crucial for cardiovascular protection.