Journal of Cardiology and Heart Failure

ABSTRACT

Informative value of systematic reviews may be limited if more and less reliable studies are analyzed together. A narrative review based on observations, qualitative analysis of the literature and plausibility of supposed mechanisms might provide some additional information. Populations exposed to elevated radiation background in the former Soviet Union are analyzed here in some detail: the areas of Chernobyl, the Urals and Semipalatinsk Nuclear Test Site. After the Chernobyl accident appeared numerous publications overestimating its medical consequences. Various limitations can be found in such studies: interpretation of spontaneous diseases as radiation-induced, indication of radioactivity or dose levels without comparison with the natural radiation background, conclusions about incidence increase without statistically correct comparison with growth tendencies for larger regions. Dose levels associated with cardiovascular derangements in experimental animals and humans undergoing radiotherapy are generally higher than averages in above-mentioned cohorts. Unrealistic cardiovascular risks at low-dose exposures call in question cancer risks reported by the same and other researchers. Pathogenetic mechanisms at low-doses are not well understood. Undoubtedly, high-dose exposure to ionizing radiation causes cardiovascular damage. It is uncertain whether low-dose chronic exposure causes measurable cardiovascular risk; further research is needed. Reliable data can be obtained in large-scale animal experiments with registration of the life duration. Current radiation protection follows the reasonable precautionary principle. Strictly observed realistic safety regulations would bring more benefit for the public health than excessive restrictions that might be violated in some countries disregarding international law, bringing economic and strategic advantages to the trespassers.

Keywords: Ionizing Radiation; Chernobyl Accident; East Urals Radioactive Trace; Semipalatinsk Nuclear Test Site; Cardiovascular Diseases