The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Abstract

Background: As low-and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources. Main text: Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low-and middleincome countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low-and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable. Conclusion: Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.

Internal Flow Choking in Cardiovascular System: A Radical Theory in the Risk Assessment of Asymptomatic Cardiovascular Diseases

“…Although the diagnostic sciences have been advanced significantly during the last eight decades [32][33][34][35][36][37][38][39][40], until the theoretical discovery of the Sanal flow choking, the real occurrence of acute-heart-failure was poorly understood, largely for the reason that it was an under diagnosis condition [2]. Now the real cause of an acute-heart-failure comes to the foreground [1,2].…”

Indicators of cardiovascular system in persons of mature age depending on a body constitution under adverse ecological conditions

“…In addition, the appearance of occupational diseases as the only indicator of negative changes in the human body is unacceptable, because in this case the level of "quality of life" is leveled, which is not determined only by the absence of disease [13]. Important in the context of this problem is that the functional changes caused by the studied environmental factors are often transient [5,6,8], or masked by the stress of adaptive capacity [4,19], and therefore often not detected in during professional medical examinations of employees [12]. The following data, in particular, are given in the study of cerebral blood flow in persons exposed to chronic ionizing radiation in residents of radiation-contaminated regions: background REG in this contingent does not exceed the age norm, but the performance of intellectual tasks of varying complexity elasto-tonic changes of the vascular bed and a certain level of regulatory changes in the circulatory system [25].…”

Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil: a small-area study

“…The issue of noise pollution in low- and middle-income countries (LMICs) has only recently started to gain more attention [ 12 ]. Assessing the health impact of aircraft noise in densely populated megacities in these countries would help quantifying the risks and the benefits of public health interventions to reduce exposure.…”