Chronic arsenic poisoning and increased risk of stroke

Abstract

Chronic arsenic poisoning is becoming an emerging epidemic in Asia and poses a major worldwide health problem. It was estimated that over 100 million people are exposed to arsenic-contaminated underground water worldwide. Epidemiological studies have shown that chronic arsenic poisoning from drinking water is associated with various atherosclerotic diseases, including ischemic stroke in a dose-response relationship. Findings from epidemiologic and mechanistic studies indicate that vascular inflammation and oxidative stress play critical roles in arsenic-induced atherosclerotic diseases. Animal models for arsenic-induced atherosclerosis illustrate that arsenic could accelerate and exacerbate atherosclerosis in apolipoprotein E-/low-density lipoprotein receptor-knockout mice. Arsenic-induced cardiovascular diseases, including ischemic stroke, may be as a result of interactions among genetics, environment as well as nutritional and metabolic factors. The cardiovascular effects of chronic arsenic poisoning have been established qualitatively and quantitatively, mostly in the high arsenic exposure areas of southwestern Taiwan. Recently, the moderate-to-low dose effect of arsenic on cardiovascular system has been found in few studies but still needs to be further confirmed in a large-scale epidemiologic studies by using proper clinical outcomes such as stroke. Stroke remains the third leading cause of mortality worldwide, and a small increased risk may indicate a large quantity of excess mortality.