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Eur Heart J. 2017 Feb 21;38(8):550-556. doi: 10.1093/eurheartj/ehw269.

Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies.

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Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany.
Danish Cancer Society Research Center, Copenhagen, Denmark.
Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
Air Quality Research Division, Environment and Climate Change Canada, Toronto, Canada.
Department of Environmental Medicine, New York University, New York, USA.
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA.


Traffic noise and air pollution together represent the two most important environmental risk factors in urbanized societies. The first of this two-part review discusses the epidemiologic evidence in support of the existence of an association between these risk factors with cardiovascular and metabolic disease. While independent effects of these risk factors have now clearly been shown, recent studies also suggest that the two exposures may interact with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention and their impact on cardiovascular disease, will be discussed in the last section of this review. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise.


Air pollution; Cardiovascular; Environmental stressors; Noise

[Indexed for MEDLINE]

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