03
Apr
Review Links Adverse Cardiovascular Effects with Exposure to Pyrethroid Pesticides
(Beyond Pesticides, April 3, 2026) A literature review published in Chemico-Biological Interactions links pyrethroid insecticide exposure to cardiac dysfunction. Through a systematic review and meta-analysis of previous research through July 2025, the authors find emerging evidence that indicates pyrethroids induce adverse cardiovascular effects through pathways of inflammation, oxidative stress, and myocardial injury (damage to the heart muscle). “The meta-analytic findings of this study offer the first comprehensive overview of the cardiotoxic effects of pyrethroids, encompassing electrophysiological, biochemical, inflammatory, and redox disturbances,†the researchers state. “Together, these findings indicate that pyrethroids disrupt cardiac electrical stability and induce cytotoxic [killing or damaging cells], inflammatory, and oxidative damage.â€
Study Importance
Scientific literature connecting various classes of pesticides to adverse health effects continues to mount, with synthetic pyrethroids emerging as a class of increasing concern. Due to their broad spectrum of activity, pyrethroids are extensively used in agriculture and land management but can persist in the environment and can cause neurotoxicity, endocrine disruption, reproductive dysfunction, and cardiovascular health implications. (See here and here.) In particular, pyrethroid exposure is associated with increased risks of developing cardiovascular disease. (See studies here, here, here, and here.)
“Cardiac electrical activity is regulated by mechanisms that are highly sensitive to oxidative stress and inflammation, which can disrupt electrophysiological stability and contribute to arrhythmogenesis [the process of developing abnormal heart rhythms],†the authors write. Due to this sensitivity, studying the effects of pyrethroid pesticide exposure gives insight regarding how electrophysiological alterations are induced and can lead to cardiac dysfunction. The researchers continue, saying, “As oxidative and inflammatory pathways are known modulators of cardiac excitability and conduction, secondary analyses focused on redox balance, inflammatory markers, and biochemical markers of cardiac injury to better understand the potential mechanisms involved were conducted.â€
Methodology and Results
In performing a literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors searched for studies across the Web of Science, Embase, and PubMed databases using a combination of keywords, including heart disease, electrophysiology, and pyrethroids. After reviewing all results through this targeted strategy, eighteen studies met the inclusion criteria, fifteen of which were included in the meta-analysis.
The authors note: “The primary outcome focused on assessing alterations in the cardiac and cardiomyocyte electrophysiological and mechanical parameters, such as action potential, heart and cardiomyocyte contractility and ionic currents, and a secondary outcome was to investigate conditions that potentially influence cardiac electrophysiological parameters, i.e., inflammation and redox state. Biochemical indicators of myocardial damage were also assessed.â€
The studies include investigations of various aspects of cardiac electrophysiology, including action potential duration, sodium current, and parameters related to cardiac contractility, as well as biochemical markers of cardiac injury, inflammatory markers such as cytokines, and the activity of antioxidant enzymes. The pyrethroid active ingredients in the studies encompass deltamethrin, beta-cyfluthrin, tefluthrin, fenpropathrin, cypermethrin, tetramethrin, and permethrin.
The results show that these pyrethroids induce cardiac dysfunction through altered electrophysiological effects, biochemical markers, inflammatory responses, and oxidative stress, among others. Notable findings include:
- Pyrethroid exposure significantly prolongs the action potential duration within cardiac muscles and significantly affects the force of contraction coefficient, both of which modulate cardiac output.
- In multiple studies, significant oxidative imbalance is noted with pyrethroid exposure. Both biomarkers and enzyme levels show alterations that can indicate oxidative injury and lead to inflammatory and cytotoxic effects.
- “Cardiac-specific biochemical markers were consistently altered across the studies. Notably, troponin I and creatine kinase-MB (CK-MB) levels were elevated following pyrethroid exposure, reflecting direct myocardial injury. Some studies also reported nonspecific markers of cytotoxicity.â€
- Altered gene expressions and chronic inflammation “can destabilize conduction and repolarization, increasing the likelihood of arrhythmic events.†(See study here.)
- “Given the role of inflammation in modulating cardiac excitability and promoting arrhythmogenesis, inflammatory mediators were evaluated in several studies.†Many levels “were consistently upregulated in response to pyrethroid exposure… Additionally, increased activity of nuclear factor kappa-light-chain-enhancer of activated B cells was observed, a key transcription factor that regulates inflammatory gene expression.â€
Many of these effects are connected. “From a mechanistic standpoint, inflammation and oxidative stress are closely intertwined, the researchers explain. They continue: “Moreover, oxidative stress can activate inflammatory signaling cascades and modulate the function of ion channels through oxidative modifications, further exacerbating electrical dysfunction… These converging lines of evidence – electrophysiological derangements, structural cytotoxicity, inflammation, and oxidative stress – highlight the multifactorial nature of pyrethroid-induced cardiotoxicity. Each of these mechanisms interacts synergistically: for example, oxidative stress promotes inflammation, which in turn can disrupt ion channel expression and function, leading to arrhythmogenesis and mechanical impairment.â€
Previous Research
Biomonitoring studies show that high urinary levels of pyrethroid metabolites are associated with alterations that lead to the development of cardiovascular disease. (See studies here and here.) The cytotoxicity noted in these studies, which occurs as a result of mitochondrial dysfunction, membrane destabilization, and increased oxidative burden, indicates not only electrophysiological changes but also structural damage and loss of cellular integrity. “When combined with electrical instability, such injury likely heightens the risk of acute cardiac events, including arrhythmias and contractile failure, particularly in individuals with pre-existing cardiovascular conditions,†the authors write.
Additional research links pesticide exposure to a “significantly increased risk of death in individuals with cardiovascular disease, such as coronary heart disease.†(See here and here.) Other studies find increased risks of stroke, myocardial infarction, hypertension, and arrhythmias in patients with elevated levels of biochemical markers of pyrethroid exposure. (See here and here.)
Aside from pyrethroids, other classes of pesticides are linked to cardiac dysfunction. One study published in Cardiovascular Toxicology finds significant associations between Gulf War deployment-related toxic chemical exposure hazards and various adverse health outcomes, including heightened risk of atherosclerotic cardiovascular diseases (ASCVDs), such as “heart attack, coronary heart disease, stroke, transient ischemic attack, and peripheral vascular disease.†The study identifies a significant association between ASCVDs in surveyed veterans who reported over 31 days of exposure to chemical and biological agents. (See Daily News here.)
A study published in Environmental Chemistry and Ecotoxicology finds that “higher pesticide exposure was significantly associated with elevated blood pressure and greater risks of hypertension.†More specifically, “[t]he results indicated that exposure to PNP [para-nitrophenol/parathion] and 2,4-D may contribute to an increased risk of hypertension.†According to data provided by the Centers for Disease Control and Prevention (CDC), roughly half of U.S. adults have hypertension, which can lead to increased risk for stroke and heart disease, two of the top causes of mortality in the nation. (See more here.)
An editorial in Expert Review of Cardiovascular Therapy finds that triazole fungicides pose a significant risk of cardiotoxicity with “growing concerns regarding their safety for human health, especially in long-term exposure,†the authors state. After analyzing the known mechanisms of cardiotoxicity of triazole pesticides in mammals, they conclude that “the most effective approach to mitigating triazole-induced cardiotoxicity lies in prevention.†(See Daily News here.)
The Organic Solution
Eliminating exposure to petrochemical pesticides and synthetic fertilizers, such as with an organic diet, mitigates disease risks including brain and nervous system disorders, cancer, endocrine disruption, and cardiovascular disease (CVD). A study in the European Journal of Preventive Cardiology finds that organic food consumption lowers the risk of developing ASCVD. This study adds to the ever-growing body of science that has linked pesticide exposure to negative effects on cardiovascular health for many decades. The findings reinforce scientific understanding that heart disease is preventable and eliminating toxics in diet can play an important role in reducing a major public health threat. (See Daily News here.)
Beyond Pesticides has extensively covered the health benefits of an organic diet and organic systems. As shared in recent coverage, titled Benefits of U.S. Organic Production Highlighted in Evidence-Based Research that Supports an Expedited Transition, a study of organic agricultural systems from 1960 to 2021 concludes that “the outlook for U.S. organic fruit and vegetables is encouraging, supported by expanding consumer demand, government support, and improved conditions for international trade.†Another study finds that adopting a fully organic diet can reduce pesticide levels in urine within just two weeks “by an average of 98.6%†and facilitate faster DNA damage repair relative to a diet of food grown with chemical-intensive practices. (See here.)
Start by Eating with a Conscience and choosing organic food to protect not only health but the environment. Beyond Pesticides’ offers tips on Buying Organic Products (on a budget!) or you can Grow Your Own Organic Food. You can also make The Safer Choice and avoid hazardous home, garden, community, and food use pesticides to protect you and your family.
All unattributed positions and opinions in this piece are those of Beyond Pesticides.
Source:
Durço, A. et al. (2026) Pyrethroid-induced cardiac Dysfunction: A systematic review and meta-analysis of preclinical evidence, Chemico-Biological Interactions. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0009279726001389.
