Research from the University of Toronto shows long-term exposure to moderate air pollution increases a person’s risk of fatty build up in the blood vessels of the heart, which can lead to serious cardiovascular events like heart attack.
As reported in the journal Radiology, the study also showed that women were particularly badly affected and had an 81% increased risk for obstructive coronary artery disease if exposed to long-term air pollution.
“Even at exposure levels below current Canadian air quality standards, long-term air pollution was independently associated with more advanced coronary artery disease—suggesting current regulations may not be fully protective and that air pollution belongs alongside blood pressure, cholesterol and smoking as a modifiable cardiovascular risk factor,” said lead author Kate Hanneman, MD, associate professor at the University of Toronto, in a press statement.
The study included 11,128 people who underwent cardiac computed tomography (CT) scans who also had available data for air pollution exposure for around 10 years. The average age was 60 years and 52% were men.
In the cohort, median 10‑year exposures were 7.5 μg/m³ for PM2.5, a common measure of particulate air pollution and 13.4 ppb for nitrogen dioxide. These levels are relatively low compared with many historical and low‑/middle‑income settings but still above the latest World Health Organization guideline of 5 μg/m³ for PM2.5 and 5.3 ppb for nitrogen dioxide.
For each addition increment of PM2.5 (1 μg/m³) people in the study had had about 11% more calcium in their coronary arteries and 13% higher odds of having more atherosclerotic plaque. For each increment of nitrogen dioxide (1 ppb) small but measurable increases in calcium (aprx 1%) and plaque (about 4%) were seen in the coronary arteries of those exposed.
After taking into account age, risk factors, medicines, and other differences, each increment higher long‑term air pollution was linked to more severe, artery‑narrowing heart disease in women, but not in men. Each increment increase in PM2.5 was associated with an 80% higher chance of women having a dangerously narrowed coronary artery and each increase in nitrogen dioxide a 6% increased chance.
There was a similar trend in men, but it was not statistically significant after correcting for possible confounding factors.
“These findings add to the growing body of evidence identifying air pollution as a modifiable risk factor for atherosclerosis,” conclude the authors.
“Considering the epidemiologic data linking air pollution to cardiovascular events, these results reinforce the urgency of global public health initiatives aimed at improving air quality to reduce cardiovascular risk.”
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