The evidence linking air pollution to cardiovascular disease (CVD) has “substantially strengthened” and high-risk individuals in particular should limit their exposure to airborne particulate matter, advise experts in an updated American Heart Association (AHA) scientific statement.
"Particulate matter appears to directly increase risk by triggering events in susceptible individuals within hours to days of an increased level of exposure, even among those who otherwise may have been healthy for years," commented lead author of the statement Robert Brook (University of Michigan, Ann Arbor, USA). Brook and co-authors reviewed epidemiologic, molecular, and toxicologic studies of the association between air pollution exposure and CVD risk published in the past 6 years. The strongest evidence found was for fine particulate matter of less than 2.5 µm (PM2.5) diameter being a cause of CVD. The major source of PM2.5 is fossil fuel combustion in industry, transport, and power generation. The AHA writing panel concluded that there is a consistent association between short-term exposure (over a few hours to weeks) to PM2.5 with CVD-related death and nonfatal events and a strong level of evidence supporting an association of longer-term air pollution exposure, ie, over a few years, with ischemic heart disease. There is also a moderate association between air pollution exposure and heart failure and ischemic stroke, and a modest amount of evidence supporting a link with peripheral vascular diseases, arrhythmias, and cardiac arrest. The panel recommends that physicians should emphasize treatment of traditional CVD risk factors, which may lessen patients’ susceptibility to air pollution, while patients with CVD should be educated about the risks. Individuals at high risk for CVD, such as the elderly and those with the metabolic syndrome or diabetes, should also be educated about the potential risks of air pollution. The statement points out that the Air Quality Index forecast – available on many media sources – should be followed to reduce exposure and limit activity, depending on the patient’s level of risk. Reducing exposure to air pollution will require efforts at the population level through national policies, Brook noted. Nevertheless, at the individual level, he maintained that "people can limit their exposure as much as possible by decreasing their time outside when particle levels are high and reducing time spent in traffic – a common source of exposure in today’s world." Read the abstract
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