Plastic pollution may be reaching the heart through the bloodstream
By European Society of Cardiology
The heart attack group also had a wider variety of plastics
in their blood. Polyethylene, one of the world’s most widely used plastics and
a common ingredient in packaging and consumer products, was the material found
most often.
Although the results do not show that plastic particles
trigger heart attacks, they add to concerns that pollution may be connected
to cardiovascular disease through inflammation, lung exposure, and
damage to blood vessels.
How Microplastics Enter the Human Body
“Micro and nanoplastics are tiny plastic particles that are
found virtually everywhere in the environment, including the air we breathe,
the water we drink, and many foods we consume,” said first author Dr. Pasquale
Paolisso of Sant’Andrea Hospital at Sapienza University of Rome, Italy. “In
recent years, scientists have begun to detect these particles in human tissues
and organs, raising concerns about their potential health effects.”
“However, very little was known about whether these
particles are present in the coronary circulation, the blood flowing through
the arteries that supply the heart, or whether environmental exposures such as
smoking and air pollution might influence their presence.”
Microplastics generally measure less than 5 millimeters (0.2
inches), while nanoplastics can be small enough to interact with cells and
biological tissues. Scientists have already reported plastic particles in human
blood, lungs, placenta, and breast milk, but their long-term health effects
remain uncertain.
Testing Blood From the Heart
The new study examined 61 patients treated at Sant’Andrea
University Hospital or Azienda Ospedaliera Universitaria Integrata of Verona,
Italy. Participants had been diagnosed with a heart attack, chronic ischemic
heart disease, or normal coronary arteries.
Researchers collected blood directly from vessels supplying
the heart and also from elsewhere in the body. This allowed them to examine
whether plastic particles were circulating in the coronary system rather than
relying only on samples taken from a vein in the arm.
The team also recorded smoking history and estimated each
patient’s air pollution exposure on the day of testing and during the previous
two years. Samples were analyzed at the Research Centre on Environmental
Pollution and Cardiovascular Diseases at the University of Campania Luigi
Vanvitelli in Naples, Italy.
Smoking and Air Pollution Raise Exposure
Smoking emerged as one of the strongest links. Smokers were
six times more likely to have microplastics in their blood than nonsmokers.
Air pollution showed a similar pattern. Patients exposed to
higher long-term levels of air pollution (PM2.5/particles measuring 2.5 μm or
less in diameter) were more likely to carry microplastics.
Every patient who smoked and had higher air pollution
exposure tested positive for plastic particles. Among people who neither smoked
nor experienced higher pollution levels, the detection rate fell to 12.5%.
A Possible Route Through the Lungs
“These findings do not prove that microplastics cause heart
attacks, but they reveal a strong association between environmental exposures,
microplastics in the blood, and cardiovascular disease,” said Professor
Emanuele Barbato of Sapienza University of Rome, who led the research and
directs the Cardiology Unit at Sant’Andrea University Hospital.
“In our study, smoking history was strongly linked to
microplastics in the blood. Our findings suggest that smoking might make it
easier for micro- and nanoplastics to enter the bloodstream via the lungs. Air
pollution may act in a similar way.”
“The results highlight the need to consider microplastic
pollution as part of the broader environmental determinants of health. Policies
that reduce air pollution, tobacco exposure, and environmental plastic
contamination could have benefits that extend beyond environmental protection
and potentially improve cardiovascular health.”
Growing Evidence of Cardiovascular Risks
In an accompanying editorial, Professor Andreas Daiber of
the University Medical Centre of the Johannes Gutenberg University in Mainz,
Germany, and his colleagues placed the findings within a growing body of
research on plastic exposure.
“Over time, plastics fragment into microplastics (<5 mm)
and nanoplastics (<1 μm), which are now detected in virtually all
environmental compartments, including air, water, and soil. Increasingly, these
particles are also found within the human body, including blood, lung tissue,
placenta, and breast milk, indicating systemic exposure.”
Previous research has also detected microplastics and
nanoplastics inside fatty plaques removed from arteries. In those patients, the
presence of plastic particles was associated with a higher risk of heart
attack, stroke, and death from any cause.
Plastics Found Inside Artery Plaques
“Until recently, the cardiovascular effects of plastic
exposure were largely speculative. However, emerging clinical evidence now
suggests a potential link between NMPs and cardiovascular disease. In patients
undergoing carotid endarterectomy, NMPs were detected within atherosclerotic
plaques, and their presence was associated with an increased risk of myocardial
infarction, stroke, and all-cause mortality.”
“In their study published in this issue of the European
Heart Journal, Paolisso et al. investigated 61 patients undergoing coronary
angiography for suspected coronary artery disease. Patients were categorized
into ST-segment elevation myocardial infarction (STEMI), chronic coronary
syndromes (CCS), and controls. Using advanced analytical methods, NMPs were
detected in both peripheral and coronary blood. Notably, plastic particle
concentrations were highest in STEMI patients, intermediate in those with CCS, and
lowest in controls.”
The heart attack patients also had higher levels of
inflammatory molecules, including tumor necrosis factor-α and interleukin-6.
These substances are involved in the immune response and are often elevated
when the body is under inflammatory stress.
Inflammation and Blood Vessel Damage
“These findings were accompanied by elevated inflammatory
markers, including tumor necrosis factor-α and interleukin-6, suggesting a link
between plastic exposure and systemic inflammation. Although limited by sample
size, these findings represent early clinical evidence that plastic particles
may be associated with acute cardiovascular events.”
“NMPs represent a rapidly emerging environmental exposure
with potentially important implications for cardiovascular health. Early
clinical evidence demonstrates that plastic particles can enter the circulation
and accumulate in vascular tissues, while experimental studies indicate that
they trigger key mechanisms of vascular injury, including oxidative stress,
inflammation, and endothelial dysfunction.”
“Although substantial uncertainties remain, the convergence
of epidemiological, clinical, and mechanistic evidence suggests that plastic
pollution may represent a previously underestimated cardiovascular risk factor.
Addressing this challenge will require coordinated efforts across disciplines
and policy domains.”
“In the era of the Anthropocene, protecting cardiovascular
health will increasingly depend on reducing not only traditional risk factors
but also the growing burden of environmental pollutants (the detrimental part
of the exposome), among which plastics may soon play a central role.”
References:
“Micro- and nano-plastics in the coronary circulation and
air pollution exposure in ischaemic heart disease presentation” by Pasquale
Paolisso, Lucia Scisciola, Marta Belmonte, Roberto Scarsini, Verdiana Galli,
Emanuele Gallinoro, Matteo Casenghi, Davide Ausiello, Giose Vincelli, Pasquale
Policastro, Marco Redivo, Francesco Cefalì, Angelo Fenti, Valeria Pellegrini,
Giovanni Falco, Simona Galoppo, Andrea Berni, Matteo Armillotta, Carmine Pizzi,
Francesco Prattichizzo, Antonio Ceriello, Michelangela Barbieri, Flavio
Ribichini, Pasquale Iovino, Philip Landrigan, Giuseppe Paolisso, Raffaele
Marfella and Emanuele Barbato, 14 July 2026, European Heart Journal.
DOI:
10.1093/eurheartj/ehag447
“Nano- and microplastics in the cardiovascular exposome: a
new frontier in environmental risk” by Andreas Daiber, Marin Kuntic and Thomas
Münzel, 14 July 2026, European Heart Journal.
DOI:
10.1093/eurheartj/ehag383
