Department of Biochemistry and Molecular Biology, University of Louisville School of Medicine, Louisville, Kentucky, U.S.A.
E. Spencer Williams
Chemrisk, Inc., Houston, Texas, U.S.A.
Epidemiologic and experimental evidence suggests that a direct correlation
exists between occupational and environmental exposure to toxic chemicals and
cardiovascular morbidity and mortality. This correlation is best exemplified by
the recognition that exposure to tobacco smoke constituents is a major con-
tributor to myocardial infarction, sudden cardiac death, arteriosclerotic periph-
eral vascular disease, and atherosclerotic aneurysm of the aorta. Similarly, recent
studies have linked exposure to airborne environmental pollutants with increased
risk for several cardiovascular diseases. Despite a wealth of new information on
mechanisms of vascular injury, slow onset and long latency periods often
obscure the relationship between toxic exposures and the development of car-
diovascular pathology. Evidence implicating lipoproteins and oxidative stress as
critical players in vascular pathogenesis continues to accumulate. A wide array
of vascular toxins affect the vessels that serve as the circuitry for the transport
and delivery of oxygen and nutrients to tissues throughout the body and for the
removal of waste products of metabolism.