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Micro- and nanoplastics in the cardiovascular system: current evidence, research gaps: a systematic review
Summary
This systematic review examined how microplastics and nanoplastics affect the heart and blood vessels. Studies in both animals and human tissue found that these particles can cause blood vessel inflammation, disrupt heart function, and were even linked to higher rates of heart attack and stroke in people with plastic particles in their arteries.
Background: Microplastics and nanoplastics (MP-NPs) are major environmental pollutants that have gained attention due to their widespread presence in water, air, soil, and food. Their entry into the human body through inhalation, oral ingestion, or skin contact raises concerns about potential health risks, particularly cardiovascular effects.Aim of the study: This systematic review aims to evaluate the impact of MP-NPs on the cardiovascular system and their associated health consequences.Material and methods: A systematic literature search was conducted in PubMed using the following keywords: "microplastics," "nanoplastics," "cardiovascular system," "cardiotoxicity," and "environmental pollution" in various combinations. Studies published between 2015 and 2025 were included, focusing on both animal and human data.Results: The review followed PRISMA guidelines, and 29 studies were included after applying predefined eligibility criteria. Most studies were conducted on animals, demonstrating that MP-NPs affect heart function through cellular and structural changes. In rat and mouse models, exposure to MP-NPs led to mitochondrial damage, myocardial fibrosis, increased pro-inflammatory markers, altered glucose and insulin levels, and weight gain. Human data remain limited; however, MP-NPs have been detected in atherosclerotic plaques, with emerging evidence suggesting their contribution to plaque formation and lipid metabolism alterations. These mechanisms may increase the risk of myocardial infarction and stroke.Conclusions: Current evidence suggests that exposure to micro- and nanoplastics (MP-NPs) may negatively affect the cardiovascular system, particularly in experimental models. Animal studies consistently indicate structural and functional myocardial changes, including fibrosis, mitochondrial damage, and metabolic disturbances. However, these findings cannot be directly extrapolated to humans. Human data remain scarce and mostly observational, showing the presence of MP-NPs in atherosclerotic plaques and thrombi, with correlations to adverse cardiovascular outcomes.Given the methodological heterogeneity and high risk of bias across available studies, the overall strength of evidence remains low. Therefore, MP-NPs should currently be regarded as a potential—but not yet proven—cardiovascular risk factor.