Microplastic and Nanoplastic Contamination as a Novel Cardiovascular Risk Factor: A Narrative Review of Pathophysiological Mechanisms and Public Health Consequences

Abstract

Abstract   Background. Microplastics (MPs) and nanoplastics (NPs), collectively referred to as MNPs, are widespread environmental pollutants detected in numerous human tissues, including blood, placenta, liver, lungs, and brain. Their potential impact on cardiovascular health has recently become an important research focus, particularly given that cardiovascular disease (CVD) remains the leading cause of death worldwide.  Aim. This narrative review summarises current evidence regarding the presence of MNPs in the human cardiovascular system, their proposed mechanisms of toxicity, and their possible association with adverse cardiovascular outcomes.  Material and methods. A non-systematic search of PubMed, Scopus, and Web of Science was conducted for publications from 2018–2025 using terms including “microplastics,” “nanoplastics,” “cardiovascular disease,” “atherosclerosis,” “oxidative stress,” and “endocrine disruption.” Relevant original studies, clinical trials, and reviews were selected based on relevance and methodological quality.  Results. MNPs have been identified in atherosclerotic plaques, where their presence was associated with a significantly increased risk of major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and all-cause mortality (HR 4.53; 95% CI 2.00–10.27; P < 0.001). Proposed mechanisms include oxidative stress, chronic inflammation, endocrine disruption, and direct cytotoxicity. Experimental studies support these pathways, although causal evidence from human studies remains limited.  Conclusions. MNPs may represent an emerging cardiovascular risk factor. Further longitudinal studies, standardised detection methods, and public health policies reducing plastic pollution are urgently required.