Author + information
- Received May 14, 2018
- Revision received July 25, 2018
- Accepted July 31, 2018
- Published online October 15, 2018.
- aHarrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio
- bCase Cardiovascular Research Institute, Case Western Reserve University, Cleveland, Ohio
- cMichigan Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan
- ↵∗Address for correspondence:
Dr. Sanjay Rajagopalan, University Hospitals, 11100 Euclid Avenue, Cleveland, Ohio 44106.
Fine particulate matter <2.5 μm (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 (∼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.
- blood pressure
- coronary artery disease
- insulin resistance
- particulate matter
- type 2 diabetes mellitus
This work was funded by National Institutes of Health grants 5R01ES019616-07 and 1R01ES026291 (to Drs. Rajagopalan and Brook). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 14, 2018.
- Revision received July 25, 2018.
- Accepted July 31, 2018.
- 2018 American College of Cardiology Foundation
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