Air Pollution, Built Environment, and Early Cardiovascular Disease

Abstract

As the world’s population becomes increasingly urbanized, there is growing concern about the impact of urban environments on cardiovascular health. Urban residents are exposed to a variety of adverse environmental exposures throughout their lives, including air pollution, built environment, and lack of green space, which may contribute to the development of early cardiovascular disease and related risk factors. While epidemiological studies have examined the role of a few environmental factors with early cardiovascular disease, the relationship with the broader environment remains poorly defined. In this article, we provide a brief overview of studies that have examined the impact of the environment including the built physical environment, discuss current challenges in the field, and suggest potential directions for future research. Additionally, we highlight the clinical implications of these findings and propose multilevel interventions to promote cardiovascular health among children and young adults.

Increased vascular stiffness in children exposed in utero but not children exposed postnatally to emissions from a coal mine fire

“…8 There is clear evidence to suggest that an adverse intrauterine environment contributes to the early development of atherosclerosis, with a long latency period from exposure to cardiovascular diseases. [8][9][10] Early precursors of vascular changes -subclinical atherosclerosis -measured by noninvasive diagnostic methods such as carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) are considered valid surrogate markers of cardiovascular risk allowing assessment of vascular changes at a very early stage. 11 CIMT has proven to provide reliable and reproducible results in pediatrics.…”

“…[12][13][14] However, it is plausible that the underlying pathophysiology of cardiovascular disease and the health consequences observed in adulthood could be driven by PM exposure in childhood. 10 Of the studies that do exist they have focused on chronic, lowintensity air pollution from ambient sources 15 and there is limited research regarding the health consequences of an acute, high-intensity air pollution episode on childhood vascular health. In addition, it has been difficult to separate the ongoing effects of postnatal exposure to PM, from the in utero and early postnatal effects.…”

Causal associations of particulate matter 2.5 and cardiovascular disease: A two-sample mendelian randomization study

“…Although the relative hazards associated with air pollution are lower than those associated with more established risk factors (such as hyperlipidemia and cigarette use), it nevertheless constitutes a danger to public health since it affects billions of people every day without their consent [1]. PM is the major component of air pollution and is made up of a variety of aerosols with different sizes and compositions, such as metals, carbon dioxide, organic species, and inorganic nitrates and sulfates [2,3]. There is broad scientific agreement that among size portions, PM2.5 is the most firmly established to have negative health consequences and is responsible for the largest worldwide public health burden [4].…”

Introduction to the Compendium on Early Cardiovascular Disease

“…The authors importantly touch on the relevance of both food and nutritional insecurity in contributing to cardiometabolic disease and poor CVH, especially in younger individuals. Along similar lines, Zhang et al 24 review data around the emerging concept of the exposome-an all-encompassing collection of internal and external features (eg, air pollution, built environment) that are thought to influence CVD-culminating in illustrations of how developing this information may led to multi-level interventions to promote healthier communities. Finally, Perry et al 25 close out the Compendium with a focus on the role of physical activity in CVH throughout the life course, beginning with promoting healthy behaviors in childhood.…”