Environmental determinants of cardiovascular disease: lessons learned from air pollution

被引:484
作者
Al-Kindi, Sadeer G. [1 ,2 ]
Brook, Robert D. [3 ]
Biswal, Shyam [4 ]
Rajagopalan, Sanjay [1 ,2 ]
机构
[1] Univ Hosp, Harrington Heart & Vasc Inst, Cleveland, OH 44106 USA
[2] Case Western Reserve Univ, Sch Med, Cleveland, OH 44106 USA
[3] Univ Michigan, Michigan Med, Ann Arbor, MI 48109 USA
[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA
关键词
FINE PARTICULATE MATTER; LONG-TERM EXPOSURE; DIESEL-EXHAUST INHALATION; HEART-RATE-VARIABILITY; BLOOD-PRESSURE; DIABETES-MELLITUS; GLOBAL BURDEN; VENTRICULAR-ARRHYTHMIAS; ULTRAFINE PARTICLES; INSULIN-RESISTANCE;
D O I
10.1038/s41569-020-0371-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A strong relationship exists between exposure to air pollution and cardiovascular events. In this Review, Rajagopalan and colleagues summarize the evidence supporting the detrimental effects of air pollution on cardiovascular health and describe the potential mechanisms involved in air pollution-mediated cardiovascular mortality. Air pollution is well recognized as a major risk factor for chronic non-communicable diseases and has been estimated to contribute more to global morbidity and mortality than all other known environmental risk factors combined. Although air pollution contains a heterogeneous mixture of gases, the most robust evidence for detrimental effects on health is for fine particulate matter (particles <= 2.5 mu m in diameter (PM2.5)) and ozone gas and, therefore, these species have been the main focus of environmental health research and regulatory standards. The evidence to date supports a strong link between the risk of cardiovascular events and all-cause mortality with PM2.5 across a range of exposure levels, including to levels below current regulatory standards, with no 'safe' lower exposure levels at the population level. In this comprehensive Review, the empirical evidence supporting the effects of air pollution on cardiovascular health are examined, potential mechanisms that lead to increased cardiovascular risk are described, and measures to reduce this risk and identify key gaps in our knowledge that could help address the increasing cardiovascular morbidity and mortality associated with air pollution are discussed.
引用
收藏
页码:656 / 672
页数:17
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