Page 22 - JCTR-11-1

Journal of Clinical and
Translational Research Pesticides and ischemic heart disease

4 Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
5 Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
6 Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
7 Department of Neurology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
8 Knowledge and Information Science, Vice Chancellor for Science and Technology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
9 Department of Improvement Plant and Seed, Agricultural and Natural Resources Research and Education Center Research, AREEO,
Yazd, Iran
10 Clinical Research Development Unit (CRDU), Moradi Hospital, Rafsanjan University of Medical sciences, Rafsanjan, Iran
11 Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences,
Rafsanjan, Iran
12 Department of Internal Medicine, Division of Cardiology, University Hospital of South Manchester NHS Foundation Trust, Manchester
M23 9LT, United Kingdom
13 Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, 26500 Patras, Greece

1. Introduction worldwide. While many factors increase the incidence
of CVD, pesticide exposure may exert harmful effects on
Currently, pesticides are considered a pivotal tool that has the cardiovascular system, with evidence suggesting that
been widely developed and used to meet the nutritional needs higher pesticide utilization correlates with a greater risk of
of the world’s growing population. Agricultural development CVD over time. In developed countries, CVD remains an
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and the adoption of diverse pest control strategies are the important cause of mortality. Iran, known as the second
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main factors contributing to the increasing use of pesticides largest pistachio (member of the cashew family) producer
worldwide, especially in developing countries. Historically, in the world after the United States, heavily relies on
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biological pesticides were applied as chemical warfare agricultural pesticides, including organophosphates and
agents during the world wars. Although the use of many
pesticides has been prohibited today, they have contributed herbicides, in its agricultural production, particularly in
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to permanent environmental pollution worldwide. Many Rafsanjan. While the biological mechanisms underlying
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pesticides degrade into several metabolites depending on the relationship between pesticide exposure and CVD are
their solubility and may persist in the environment for still unknown, further research on this topic is critical.
decades. This issue is further compounded by the alarming The purpose of this study is to determine the relationship
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rise pesticide utilization around the world, especially in between pesticide exposure and ischemic heart disease
industrial countries such as Iran. It has been reported that (IHD). While some studies have reported the negative
more than 3.5 million tons of pesticides have been used effects of pesticides on heart health, limited data exist on
in 2020. Table 1 illustrates the currently used pesticides the influence of personal habits, lifestyle, demographic
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worldwide and their respective modes of action. characteristics, history of comorbidities, and physical
Some studies have shown an association between activity in the context of pesticide exposure and heart
pesticide exposure and an increased risk of cardiovascular disease. Therefore, in the present study, we investigated the
disease (CVD). Berg et al. investigated the relationship effects of pesticide exposure on CVDs in the population
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between occupational exposure to pesticides and the that participated in the Rafsanjan cohort study (RCS).
incidence of CVD in Japanese American men. The 2. Methods
results revealed that occupational pesticide exposure
was associated with a higher incidence of coronary 2.1. The study population
heart disease or cerebrovascular events. Similarly, many This cross-sectional study aimed to investigate the
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agrochemical products have been linked to an increased association between pesticide exposure and the prevalence
risk of myocardial infarction (MI), congestive heart failure, of IHD among participants aged 35 – 70 years in the RCS.
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stroke, arrhythmias, and sudden death among pesticide RCS is part of the Prospective Epidemiological Research
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factory workers and individuals exposed to pesticides. Studies in IRAN (PERSIAN), and was launched in August
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A systematic review of agrochemicals also reported a close 2015 in Rafsanjan, a region in southeastern Iran. The
correlation between agrochemical use and CVD. 8 study was designed to recruit a total of 10,000 participants
According to the World Health Organization (WHO), (2,500 from each of four pre-determined urban and
CVD is recognized as one of the key causes of death suburban areas of Rafsanjan) from both genders, aged
Volume 11 Issue 1 (2025) 16 doi: 10.36922/jctr.22.00187