Air Pollution Increases Risk of CVD

Journal Scan | There are abundant data demonstrating that air pollution contributes to the risk of cardiovascular disease (CVD) and associated mortality. The Global Burden of Disease study has estimated the worldwide impact of air pollution with as many as 3.1 million of 52.8 million all-cause and all-age deaths being attributable to ambient air pollution in 2010; air pollution is ranked ninth among the modifiable disease risk factors and accounts for 3.1% of global disability-adjusted life years.

In a document prepared on behalf of the European Society of Cardiology, David E. Newby, MD, and colleagues aimed to highlight and raise awareness of the impact of air pollution on CVD and provide guidance on the potential health impacts of air pollution. The panel also provided recommendations for future public health and research priorities to “manage and mitigate this avoidable cause of death and disease.”

According to the authors, air pollution exacerbates existing heart conditions and also has a role in the development of the disease. There is powerful evidence of the adverse effects of airborne particulate matter (PM) compared with gaseous pollutants.

The majority of cohort studies have established a link between long-term exposure to air pollution with an increased risk of incident fatal or non-fatal coronary artery disease. Several studies have examined associations of air pollution with subclinical atherosclerosis. Evidence from longitudinal studies investigating the progression of subclinical atherosclerosis is growing, providing support for the hypothesis that chronic exposure to air pollution has an influence on the development of atherosclerosis and increases the risk for coronary artery disease.

A national cohort study conducted in England found an association between long-term exposure to PM and nitrogen dioxide and an increased incidence of heart failure (HF). Moreover, a systematic review and meta-analysis of current data demonstrated a positive association between short-term increases in gaseous components and PM with the risk of hospitalization or death from congestive HF.

“Efforts to reduce exposure to air pollution should urgently be intensified, and supported by appropriate and effective legislation…Air pollution should be viewed as one of several major modifiable risk factors in the prevention and management of CVD. Further research should explore the optimal methods of air pollution reduction and document the effects of this on the incidence of CVD and related mortality in order to pressurize policy makers to intensify the efforts required for effective legislation on air pollution reduction,” the authors said.

Newby DE, Mannucci PM, Tell GS, et al. Eur Heart J. 2014;doi:10.1093/eurheartj/ehu458.

Keywords: ACC Publications, CardioSource WorldNews

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