Irradiations à faibles doses et risque de pathologie cardiovasculaire : revue des études épidémiologiques

Background. - While cardiovascular risks associated with high level of ionizing radiation are well-established, long-term effects of low and medium levels of exposure, between 0 and 5 gray (Gy), on the cardiovascular system are debated. Methods. - Available literature was reviewed considering various populations, such as survivors of atomic bombs, nuclear workers, Chernobyl liquidators, radiologists and radiological technologists and patients exposed for medical reasons. Results. - A significant increased risk of cardiovascular diseases associated with low doses of ionizing radiation was observed in 13 studies among the 27 analyzed. The ischemic heart diseases risk was detailed in 16 studies and seven of them showed a significant increase. The cerebrovascular risk was significantly increased in five studies among the 12 considered. Conclusion. - Some epidemiological and experimental data are clearly in favour of an increased cardiovascular risk associated with exposure to low doses. However, given the multifactorial origin of cardiovascular diseases and the lack of a clear pathophysiologic mechanism, epidemiological results have to be carefully interpreted. Further research should be conducted in this area. (C) 2009 Elsevier Masson SAS. All rights reserved.