The relation between trace elements and human health has been scarcely studied. With respect to cardiovascular diseases and hypertension attention has mostly focused on arsenic, cobalt, copper, chromium, fluorine, manganese, vanadium, zinc, selenium, silicon, cadmium, and lead. Environmental contamination can influence organ concentrations through long-term, low-level effects. This article reviews the present knowledge obtained by epidemiological, biochemical and cell biological studies. Attention is paid to interpretation problems due to the complexity of biochemical interactions with proteins of various sorts which determine metabolic processes and to the occurrence of detoxification mechanisms in which trace elements interact. This can also lead to strong variations in individual vulnerability. In general, the elements selenium, copper, zinc, chromium, and manganese seem to counteract the development of cardiovascular diseases, whereas cadmium and may be lead seem to stimulate it. Effects of arsenic, silicon and fluorine are unclear and for cobalt absent. The intensity of these effects on public health is difficult to measure, but is as yet probably limited except in extra-ordinary situations.