A balanced diet bundled with an active lifestyle is no longer enough to keep your heart healthy. It has now been proven that the quality of air you breathe also has a direct bearing on cardiac wellness. According to a research article published in the Journal of American Heart Association (JAHA) in August 2023, particulate matter (PM) pollution was attributed as the causative factor for around 3.5 million deaths from cardiovascular diseases in 2019. It has also recorded a 121 percent rise in the number of deaths globally due to air pollution in the last three decades.
“Recent research has confirmed that there is a link between cardiovascular disease and air pollution. The latter could have a significant effect on physiological processes, which could result in heart attacks or strokes,” says Dr Prashant Pawar, consultant, cardiology, Fortis Hiranandani Hospital, Vashi, Navi Mumbai.
Cardiovascular disease and air pollution
The World Health Organisation’s (WHO) maiden global report on hypertension released on 19 September 2023 has also listed air pollution as one of the foremost factors responsible for the prevalence of hypertension and poor cardiovascular health. Other causes include tobacco and alcohol usage, a sodium-rich unhealthy diet, and physical inactivity. The report also states that air pollution is one of the factors responsible for at least 6.7 million deaths annually across the globe due to various health complications.
“Ischemic heart disease (coronary heart disease) and stroke are among the main diseases attributable to air pollution exposure,” the report states.
The link between air pollution and cardiovascular disease
The findings published in JAHA, based on the data collated from the Global Burden of Disease report between 1990 and 2019, highlight the drastic increase in the number of deaths caused due to PM pollution. “It has been proven that particulate matter in the air could trigger severe inflammation, oxidative stress and injury at the cellular level,” says Dr Pawar.
Dr Ravindranath Reddy, head of department, interventional cardiologist, BGS Gleneagles Global Hospital, Bengaluru, shares that some studies reveal an increase in the risk of cardiovascular conditions in people exposed to prolonged air pollution by at least eight to ten percent. “Exposure to polluted air could lead to chronic and acute inflammation. It also increases the risk of arterial blockages, endothelial dysfunction and even blood clot formation. These, in turn, increase cardiac risk,” says Dr Reddy.
The JAHA article also points out that as per the data, men were more affected than women by air pollution-induced heart health complications.
Other effects of air pollution
Dr Pawar points out that prolonged exposure to polluted air, especially that with high quantities of nitric oxides from vehicular and industrial emissions, is responsible for various health conditions including early onset of atherosclerosis. “Air pollution is now being seen as one of the main causative agents of not just cardiovascular disease but also for other non-communicable diseases like diabetes,” Dr Pawar adds.
The way forward
“It is true that most people were not aware of the link between air pollution and cardiac conditions, even up to five years ago. But now awareness is being created, especially as air pollution in most cities, including Delhi, has risen considerably in recent years,” Dr Reddy shares.
Dr Pawar also points out that doctors now consider factors like air pollution alongside traditional risk factors like obesity, high cholesterol, unhealthy lifestyle, tobacco use and genetics when treating people with cardiac conditions.
“In fact, I am part of a group of cardiologists researching the ill effects of air pollution on heart health in India. We will be collecting data from different parts of India and collating it with scientific explanation to be published in peer-reviewed journals,” Dr Pawar adds.
The recent WHO report also cites that 99 percent of the global population is exposed to unhealthy and polluted air on a daily basis. Hence, it has called out for policy-level intervention to tackle both air pollution and its related diseases. Further, adequate focus on personal health and adopting a cardiac-friendly diet and lifestyle and lowering cholesterol risk have become crucial.
Air pollution has emerged as one of the main risk factors for cardiovascular disease. The WHO’s recent report on global hypertension has cited air pollution as one of the main factors responsible for coronary artery disease and stroke. A recent article published in JAHA also acknowledged that air pollution is one of the main factors responsible for at least 3.5 million cardiovascular deaths in 2019. Doctors have now started considering factors like air pollution alongside traditional risk factors while treating cardiac conditions.