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Curr Epidemiol Rep. 2018 Dec;5(4):370-378. doi: 10.1007/s40471-018-0166-8. Epub 2018 Sep 19.

Air Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide.

Author information

1
St. Luke's Hospital, Department of Medicine, Chesterfield, MO, USA.
2
Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.
3
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
4
Department of Environmental Health Sciences, Columbia University School of Public Health, New York, NY, USA.
5
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.

Abstract

Purpose of review:

Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations.

Recent findings:

Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations.

Summary:

Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.

KEYWORDS:

Air pollution; Atherosclerosis; CVD; Global Health; Mortality; Risk factors; Vulnerable populations

PMID:
30931239
PMCID:
PMC6435302
[Available on 2019-12-01]
DOI:
10.1007/s40471-018-0166-8

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