Link Between Urinary Metal Levels and Increased Heart Failure Risk

Recent research conducted by Columbia University's Mailman School of Public Health has uncovered a significant association between exposure to specific metals, detected through urine analysis, and a higher likelihood of developing heart failure (HF). This large-scale, multi-cohort study is the most comprehensive to date, emphasizing the importance of monitoring environmental metal exposure as part of cardiovascular health strategies.

The study analyzed data from over 10,000 adults spanning diverse racial, ethnic, and geographic backgrounds, including cohorts from the United States and Spain. Researchers measured metal levels in urine samples—an indicator of body burden and elimination of metals—and collected extensive health and lifestyle data. Advanced machine learning models evaluated the combined effects of five urinary metals: arsenic, cadmium, molybdenum, selenium, and zinc.

The findings revealed that higher levels of these metals as a mixture correlated with an increased risk of heart failure: 55% in rural American Indian populations, 38% in urban and diverse American populations, and 8% in Spanish adults. When examined individually, doubling the urine concentrations of cadmium, a toxic metal common in tobacco, food, and industrial waste, was linked to a 15% higher risk of HF. Similarly, increased levels of molybdenum and zinc were associated with 13% and 22% higher risks, respectively. While essential for biological functions, excessive levels of zinc and selenium can be harmful.

The study highlights that exposure sources vary, including industrial activities, contaminated water, air pollution, smoking products, and certain foods. Notably, populations exposed to higher environmental contaminant levels—such as the studied cohorts—showed a consistent pattern of elevated HF risk. Researchers emphasize the urgent need for public health initiatives to reduce exposure, particularly among vulnerable communities.

Columbia experts, including lead author Irene Martinez-Morata and senior author Ana Navas-Acien, advocate for increased efforts to monitor and limit environmental metal exposure. Future investigations aim to understand the biological mechanisms linking metal toxicity to heart failure and explore environmental interventions for prevention. Overall, this study underscores the critical role environmental factors play in cardiovascular disease risk and the importance of minimizing harmful metal exposures.

For more details, see the original publication in JACC: Heart Failure: [DOI: 10.1016/j.jchf.2025.03.046]