In this study, we investigated the risk of cardiovascular disease (CVD) in individuals exposed to arsenic (As) and to identify potential biomarkers. The results revealed that the FRS was positively correlated with the MMA content and MMA% but negatively correlated with the DMA% and SMI, while the AIP index was positively correlated with the DMA, MMA, MMA%, iAs, tAs and As content. In addition, ADMA was positively correlated with MMA and MMA% and negatively correlated with the SMI and DMA%. Regression models showed that ADMA and ICAM1 were positively correlated with CVD risk. Mediation analysis indicated that ADMA and ICAM1 mediated the association between As exposure and CVD risk. In conclusion, the risk of CVD is higher in residents previously exposed As. Endothelial injury appears to mediate the increased risk of As-induced CVD, and both ADMA and ICAM1 may serve as potential biomarkers for the early identification of this process.
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