The incidence of virtually every chronic disease in almost every age group has increased relentlessly the past half century. A growing body of research has now documented that much, if not most, of this increase is due to the increasing levels of toxic metals and chemicals in the environment. Heavy metals (eg, cadmium, lead, and mercury), meta-metals (eg, arsenic), nonpersistent chemical toxins (eg, PAHs [polyaromatic hydrocarbons], VOCs [volatile organic compounds], glyphosate, organophosphate pesticides), persistent chemical toxins (DDT [dichlorodiphenyltrichloroethane], PCBs [polychlorinated biphenyls], air pollutants (particulate matter, ozone, sulfur, and nitrogen oxides), and several other less pervasive, but still important, classes of toxicants, have all been shown to increase cardiovascular disease (CVD) and many other diseases as well as risk of death. These toxicants contaminate air, water, health and beauty aids, food, packaging, pharmaceuticals, house and yard chemicals—in other words every human contact with the environment.
Everyday exposure to many of these is common, but making the problem far more challenging is that many of them have very long half-lives in humans. Although simple avoidance is critical, substantial skill and effort are needed to help facilitate excretion of the persistent organic pollutants (POPs). The long lifetimes of lead in the body is well known. But far less recognized is that many of these new-to-nature molecules were specifically designed to be difficult to detoxify by biological systems. Particularly problematic for humans are the halogenated compounds. Without intervention, molecules like DDT and PCBs have half-lives measured in years to even decades, causing continuous, unrelenting, cumulative damage. A key reason so much disease occurs later in life is that these long half-lives result in progressively higher body levels as age increases.
This chapter focuses on the worst of the toxicants shown to induce CVD, where they come from, how their body load is assessed, and key strategies for increasing excretion from the body. Well recognized toxins like smoking are addressed elsewhere. Those who want to dive more deeply into the huge role of environmental toxins in chronic disease are encouraged to read Crinnion and Pizzorno, Clinical Environmental Medicine, Elsevier, 2018.
Cardiovascular Diseases Caused or Aggravated by Environmental Toxicants
The key toxicants for each cardiovascular dysfunction/disease are listed alphabetically to avoid misplaced concreteness. Although some toxicants are clearly worse than others, there is huge variability according to each person’s biochemical individuality, nutritional status, and exposure to other toxicants. Another challenge is that research on chronic, low level exposure to toxicants and disease risk as well as mechanisms of damage is still at an early stage. Some toxicants may appear worse simply because they have been subjected to more research or, like lead, have been damaging humans for much longer. This list includes those toxicants that increase disease risk at least 20% and have substantial research support. Also, of substantial significance is the fact that people are rarely exposed to a single toxicant. Because the average person is exposed to multiple toxins, their damaging effects are amplified (Table 34.1