Impact of the Environment on Cardiovascular Health

Environmental pollution is responsible for more deaths globally than many common risk factors, wars and famines combined, contributing to 9 million annual deaths globally. Air pollution is by far the most important environmental risk factor, contributing inordinately to global mortality, with substantial evidence to suggest a causal role for air pollution in mediating cardiovascular events. Although air pollution is a heterogeneous mixture that includes gases, fine particulate matter (<2.5 μm; PM2.5) has the greatest strength of evidence for health effects and is the main focus of health research and regulatory standards. In this chapter, we discuss the evidence linking the universe of known environmental pollution (air pollution, noise, metallic and synthetic chemicals) with cardiovascular and metabolic disease and provide an overview of epidemiologic evidence and biologic mechanisms. A practical approach for evaluation and mitigation of pollution cardiovascular risk, both from personal and societal perspective, is provided.