chapter  14
54 Pages

Chapter 14

ByKenneth S. Ramos, E. Spencer Williams

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.

INTRODUCTION

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.