Air Pollution and Cardiovascular Disease: a Focus on Vulnerable Populations Worldwide

Abstract

Purpose of review: Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations. Recent findings: Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations. Summary: Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.

Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research

“…However, little previous work has applied this framework to understand multilevel factors associated with healthcare and research distrust, identify racial/ethnic differences in these factors, or describe the perspectives of deaf/hearing impaired individuals. Participants identified ongoing concerns in their neighborhoods that increase risks for cardiovascular disease, such as exposure to environmental pollutants [27]—which have implications for trust. The findings from this study can inform institutional efforts to better serve patients and communities, and policy briefs (e.g., city, state, national) to achieve health equity.…”

Combustion- and friction-derived magnetic air pollution nanoparticles in human hearts

“…A critical component of the air pollution mix is particulate matter (PM). Epidemiological studies show that acute and chronic exposures to PM increase the risk for cardiovascular (CV) morbidity and mortality (Dockery et al, 1993;Lucking et al, 2008;Brook et al, 2010;Mills et al, 2011;Rajagopalan et al, 2018;Tibuakuu et al, 2018;Malik et al, 2019). However, the causal links between specific PM components and health impact are not clear; pathways suggested as playing a role in the development, morbidity and mortality of PM-related CV diseases include pulmonary and systemic oxidative stress and inflammation, endothelial dysfunction, imbalance of the autonomic nervous system and arrhythmogenesis (Brook et al, 2010;Rajagopalan et al, 2018).…”

Association of Fine Particulate Matter and Risk of Stroke in Patients With Atrial Fibrillation

“…Ambient air pollutants, especially fine particulate matter measuring 2.5 μm or less (PM 2.5 ), are associated with cardiovascular risk. 4 Multiple studies 5 , 6 , 7 , 8 , 9 , 10 have established the associations between short-term (diurnal) and long-term (multiyear) PM 2.5 exposures with cardiovascular events. PM 2.5 has been identified as having a causal relation to cardiovascular disease and being the foremost environmental risk factor for cardiovascular events, 4 , 11 including stroke and stroke-related mortality.…”