Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta‐analyses

Abstract

The available evidence on the effects of ambient air pollution on cardiovascular diseases (CVDs) has increased substantially. In this umbrella review, we summarized the current epidemiological evidence from systematic reviews and meta‐analyses linking ambient air pollution and CVDs, with a focus on geographical differences and vulnerable subpopulations. We performed a search strategy through multiple databases including articles between 2010 and 31 January 2021. We performed a quality assessment and evaluated the strength of evidence. Of the 56 included reviews, the most studied outcomes were stroke (22 reviews), all‐cause CVD mortality, and morbidity (19). The strongest evidence was found between higher short‐ and long‐term ambient air pollution exposure and all‐cause CVD mortality and morbidity, stroke, blood pressure, and ischemic heart diseases (IHD). Short‐term exposures to particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) were consistently associated with increased risks of hypertension and triggering of myocardial infarction (MI), and stroke (fatal and nonfatal). Long‐term exposures of PM2.5 were largely associated with increased risk of atherosclerosis, incident MI, hypertension, and incident stroke and stroke mortality. Few reviews evaluated other CVD outcomes including arrhythmias, atrial fibrillation, or heart failure but they generally reported positive statistical associations. Stronger associations were found in Asian countries and vulnerable subpopulations, especially among the elderly, cardiac patients, and people with higher weight status. Consistent with experimental data, this comprehensive umbrella review found strong evidence that higher levels of ambient air pollution increase the risk of CVDs, especially all‐cause CVD mortality, stroke, and IHD. These results emphasize the importance of reducing the alarming levels of air pollution across the globe, especially in Asia, and among vulnerable subpopulations.

Short-term ambient air pollution exposure and risk of atrial fibrillation in patients with intracardiac devices

“…However, our findings are only suggestive and further studies are needed to determine a conclusive pathophysiological pathway. 37 …”

Body Mass Index Modulates the Impact of Short-Term Exposure to Air Particulate Matter on High-Density Lipoprotein Function

“…In the literature, there is evidence of an association of both short- and long-term exposures to environmental pollutants with cardiovascular morbidity and mortality [ 27 ]. Long-term exposure could favor the development and progression of atherosclerosis by establishing a chronic low-grade inflammatory state and by upregulating the sympathetic nervous system [ 3 ].…”

Korzyści środowiskowe i zdrowotne jako efekt realizacji polityki klimatycznej i rozwoju energetyki rozproszonej

“…Wiele badań naukowych potwierdza wpływ długotrwałego wdychania zanieczyszczonego powietrza na występowanie przewlekłych chorób układu krążenia i układu oddechowego, a także chorób nowotworowych, w szczególności raka płuc (de Bont et al 2022, Wang et al 2022. Oddychanie zanieczyszczonym powietrzem przyczynia się do powstawania stanów zapalnych, a po długotrwałym narażeniu powoduje uszkodzenia DNA (Krzyżanowski et Cohen 2008, Raport HEAL 2013, Krzyżanowski 2016, Jędrak et al 2017, Chen et al 2019.…”