Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 72, Issue 17, Pages 2054-2070Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.07.099
Keywords
blood pressure; coronary artery disease; environment; insulin resistance; particulate matter; type 2 diabetes mellitus
Categories
Funding
- National Institutes of Health [5R01ES019616-07, 1R01ES026291]
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Fine particulate matter <2.5 mu m (PM2.5) air pollution is the most important environmental risk factor contributing to global cardiovascular (CV) mortality and disability. Short-term elevations in PM2.5 increase the relative risk of acute CV events by 1% to 3% within a few days. Longer-term exposures over several years increase this risk by a larger magnitude (similar to 10%), which is partially attributable to the development of cardiometabolic conditions (e.g., hypertension and diabetes mellitus). As such, ambient PM2.5 poses a major threat to global public health. In this review, the authors provide an overview of air pollution and health, including assessment of exposure, impact on CV outcomes, mechanistic underpinnings, and impact of air pollution reduction strategies to mitigate CV risk. The review concludes with future challenges, including the inextricable link between air pollution and climate change, and calls for large-scale trials to allow the promulgation of formal evidence-based recommendations to lower air pollution-induced health risks. (c) 2018 by the American College of Cardiology Foundation.
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