Multiscale Modeling Identifies Cardiovascular Risk from Common Chemical Exposures

BackgroundThe cardiovascular system is significantly affected by exogenous factors, but understanding the risks posed by pharmaceuticals and environmental chemicals is restricted due to limited data availability. New approach methodologies (NAMs) apply in vitro, in chemico, and in silico methods to characterize hazard and risk, thus offering rapid, multiscale human biology-based strategies to overcome regulatory challenges and the potential to complement or replace animal testing for understanding chemical cardiovascular effects. MethodsIn the present study, we applied a systems-based workflow using physiologically based pharmacokinetic (PBPK) models to convert bioactive concentrations from >300 high-throughput screening (HTS) assays with cardiovascular-relevant molecular and cellular targets to human equivalent administered doses (EADs) for >800 substances with widespread human exposure potential. To derive human-relevant risk predictions, the in vitro activity-derived EADs were compared with human exposure estimates and in vivo points of departure (PODs) from toxicological animal studies. For a subset of chemicals, we applied a geospatial analysis to assess the combined risks for populations across regions of the US. ResultsThe combined HTS assay data, human exposure predictions, animal study-based PODs, geospatial exposure data, and PBPK modeling identified compounds with potential cardiovascular toxicity at relevant exposure levels. Personal care product ingredients, flame retardants, herbicides, pesticides, pharmaceuticals, and byproducts of various industrial processes were noted as agents of concern preferentially targeting endothelial cell signaling, nuclear hormone receptors, and other critical cardiovascular targets. Of the 859 chemicals assessed, in vitro CV-relevant assays were more risk protective than animal studies for 96.4% of the chemicals. A set of 17 chemicals had a log10 bioactivity exposure ratio (BER) below -2, indicating estimated human exposure more than 100-fold above the in vitro-derived bioactive dose. ConclusionsThis study establishes an integrative, multiscale framework linking molecular perturbations to population-level cardiovascular risk, enabling systematic identification of potentially cardiotoxic chemicals and the communities most vulnerable to their effects. By bridging mechanistic toxicology with pharmacokinetic modeling and epidemiologic context, this approach enhances the biological relevance and translational impact of human health risk assessment. This scalable, adaptable framework supports timely, evidence-based decision-making and aligns with the growing adoption of NAMs to advance cardiovascular research and disease prevention. Novelty and SignificanceO_ST_ABSWhat is known?C_ST_ABSHigh-throughput screening (HTS) assays can identify chemicals with activity at cardiovascular (CV) relevant molecular targets, but translating in vitro bioactivity concentrations into biologically meaningful human equivalent doses requires physiologically based pharmacokinetic (PBPK) modelling. The bioactivity exposure ratio (BER) provides a data-driven metric for comparing in vitro-derived equivalent administered doses against population exposure estimates, but its application to CV endpoints across a large and chemically diverse environmental chemical landscape has not been demonstrated. Geospatial mapping of CV chemical exposure risk has been demonstrated for a limited set of air pollutants but has not been extended to a broad environmental chemical landscape using human-relevant in vitro bioactivity data. What new information does this article contribute?Integrated in vitro to in vivo extrapolation (IVIVE) across 859 environmental chemicals demonstrates that cardiovascular-relevant in vitro endpoints are sensitive indicators of broader systemic toxicity, 96.4% of chemicals showed positive POD ratios, meaning in vitro CV assays flagged hazard at lower doses than non-specific animal toxicity studies despite the absence of endpoint matching. Seventeen chemicals including PFAS, brominated flame retardants, endocrine disruptors, and agricultural herbicides, had a BER below -2, indicating estimated human exposure more than 100-fold above the in vitro-derived cardiovascular bioactive dose, with convergent evidence from both in vitro and in vivo data supporting regulatory priority. County-level geospatial mapping reveals that cardiovascular chemical exposure risk is geographically heterogeneous across the United States, concentrated in industrially active regions already associated with elevated cardiovascular disease mortality, identifying specific populations for targeted environmental monitoring. SummaryThis study presents a scalable, systems-based IVIVE framework that integrates cardiovascular-relevant in vitro HTS bioactivity data with reverse dosimetry, population exposure predictions, and in vivo animal toxicity data to prioritize environmental chemicals for cardiovascular risk assessment. Applied to 859 chemicals spanning personal care products, flame retardants, pesticides, pharmaceuticals, and industrial compounds, the framework demonstrates that CV-relevant in vitro endpoints are sensitive indicators of systemic toxicity even in the absence of direct endpoint matching with in vivo studies. The BER emerges as a flexible and resource-adaptable prioritization metric, identifying 92 chemicals where estimated human exposure falls within the CV bioactive range, of which 17 represent the highest regulatory priority based on convergent evidence from both data streams. Geospatial mapping further reveals regional heterogeneity in cardiovascular chemical exposure risk concentrated in industrial areas of the central and southeastern United States. This work advances the application of new approach methodologies for cardiovascular chemical risk assessment at a time of accelerating regulatory transition toward human-relevant in vitro-based safety evaluation, providing a reproducible computational workflow directly applicable to chemical prioritization under evolving EPA and FDA regulatory frameworks.