Wir leben im sogenannten Plastikzeitalter. Plastik ist ein künstliches Material, welches aus Erdöl hergestellt wird und in der Regel durch chemische Prozesse aus kleineren Bausteinen, den sogenannten Monomeren, aufgebaut ist. Plastik hat eine Polymermatrix mit tausenden von chemischen Zusätzen für Farbe und Stabilität. Wir verbrauchen 40 kg Plastik pro Kopf pro Jahr, in Europa vermutlich das Doppelte. Wir benötigen Plastik in unserem Alltag ununterbrochen – ohne Kunststoffe wären Medizin, Technologie, selbst Kultur (Musikstreaming, Malfarben) sowie die Fischerei im Meer nicht möglich. Plastik findet sich auch in Verpackungen, Kosmetika, Kinderspielzeug oder sogar in medizinischen Produkten. Plastik ist aber nicht einfach gebunden. Beim Waschen von 6 Kilogramm synthetischer Kleidungsstücke in der Waschmaschine werden hunderttausende von Plastikpartikeln freigesetzt. Was bedeutet es für unseren Körper und unser Herz? Plastik stellt ein großes Problem für Umwelt und Tiere dar. Die Langzeitschäden dieser Plastikexposition sind nicht ausreichend bekannt. In den letzten Jahren haben sich über fünf Milliarden Tonnen Plastik in der Natur abgelagert. Es wird tausende von Jahren dauern, bis sich dieses Plastik abbauen kann. Plastik zerfällt dabei in fast unsichtbare Mikropartikel – in Mikroplastik (d. h. < 5 mm groß) oder Nanoplastik (d. h. < 1 mm). Die Erde baut Plastik in ihre Kreisläufe ein; man findet Plastik in den Fischen, in der Leber und im Fett des Menschen beispielsweise. Mikroplastik wird mit der Luft und über Gewässer, d. h. Seen und Flüsse, transportiert. Mit jedem Schluck Wasser nehmen wir Polyethylenterephthalat (d. h. PET) auf, ein Polyester. Gemäß der WHO sei Plastik in Lebensmitteln kein Problem für den Menschen – im Gegensatz zu Meerestieren und Seevögeln, die daran verenden können. Plastik kann zwar schützende Eigenschaften haben und die Wirkung von Pestiziden vermindern sowie Fischen oder Meeresorganismen auch als Lebensraum dienen. Viele Tierstudien konnten keine negative Wirkung von Mikroplastik zeigen. Dennoch: Es gibt keine Entwarnung. Es wurden Angiosarkome der Leber nach beruflicher PVC-Exposition beschrieben. Und wir werden vielen potenziell schädlichen Stoffen neben Plastik wie Medikamentenresten, Röntgenkontrastmitteln etc. ausgesetzt. Zudem: Die Wirkung des Mikroplastiks auf das Klima ist schwer abzuschätzen. Plastik ist bereits Teil der Gesteine; was damit auf die Länge geschieht, bleibt offen.
So what about the cardiovascular system?
Polyethylene and PVC in the plaques of the arteries
In addition to normal exposure through the environment, there are also certain devices and implants in cardiology that are made of plastic. Side effects have rarely been described. However, plastic enters the bloodstream via the intestine, especially polyethylene and PVC.
Micro- and nanoplastics (MNPs) can then be deposited in arteriosclerotic plaques and thus increase the cardiovascular risk. Animal experiments and cell cultures show that MNPs accumulate in highly vascularized tissue and in the heart after inhalation or eating. Inflammatory reactions are triggered by plastic.
In March 2024, a study by Marfella et al. was published in the best scientific journal in medicine(New England Journal of Medicine) on how much MNP (mainly particles smaller than 0.2 mm) is present in the plaques of high-grade stenoses of the arteries leading to the brain (carotids) (257 patients). 58.4 % had polyethylene and 12.1 % PVC in the plaques. The patients were observed for 33.7 ± 6.9 months. Patients with MNPs in the plaques had a 4.53-fold higher risk of myocardial infarction, apoplexy or death. However, this does not prove that the polyethylene and PVC in the plaques is really responsible for this.
Nevertheless, we in cardiology also need to be aware of plastics and be aware that exposure to high levels of MNP may represent an additional cardiovascular risk factor.
Plasticizers (phthalates) as a cause of cardiovascular diseases
Another aspect of plastic are the so-called plasticizers in plastic, the so-called phthalates. For a long time they were considered unproblematic, but phthalates also pose an underestimated risk to our heart health. Phthalates make plastic elastic and are found in a large number of everyday products. However, phthalates are endocrine disruptors - substances that can interfere with the hormone system. They enter our bodies via food packaging, cosmetics or the air. Researchers at NYU Langone in New York recently analyzed data from over 200 countries. The focus was on DEHP (di-2-ethylhexyl phthalate), one of the most commonly used phthalates. The researchers showed that around 350,000 deaths worldwide in 2018 could be attributed to exposure to DEHP, particularly in the 55 to 64age group. This would correspond to around 13% of all cardiovascular deaths in this age group. Most cases occurred in Asia, the Middle East and the Pacific region. However, we also come into contact with phthalates on a daily basis in Europe and Switzerland. Phthalates can promote inflammation in the blood vessel walls and arteriosclerosis. They can also cause hormonal changes that increase the risk of heart disease. They may also lead to an increase in other risk factors such as high blood pressure, obesity or diabetes.
What is it like in everyday life? Phthalates cannot be completely avoided - but everyone can reduce their exposure. For example, plastic should not be heated (e.g. in the microwave) and food should be stored in glass, stainless steel or ceramic wherever possible. Cosmetics and cleaning products should be checked critically: If the ingredients are unclear, such as "perfume" or "fragrance", they may contain phthalates. Preference should be given to fresh, minimally processed foods - this also reduces plastic packaging. In the EU and Switzerland, some phthalates are already restricted, especially for use in toys or baby products. However, there are still exceptions in certain areas, such as medical devices. It is therefore important that research and authorities continue to monitor the issue closely.
The new study makes it clear that chemicals in plastics could play a greater role in cardiovascular disease than previously assumed. We can reduce our exposure to plastics by making small changes in our everyday lives. Further research is urgently needed to show the extent of the impact of plastic products.
Sources
- Trasande L. et al. Phthalate exposure and cardiovascular mortality: a global burden analysis. 2025.
- CNN Health. Plastic chemicals may be linked to 350,000 deaths from heart disease, study finds. April 29, 2025.
- Washington Post. Plastic chemicals may be linked to hundreds of thousands of deaths from heart disease. April 29, 2025
- Marfella et al. New England Journal of Medicine 2024
