"Comprehensive strategies to mitigate pollution and climate change are paramount to protect the environment and safeguard human health globally," say leading global experts as part of a two-part JACC Focus Seminar on pollution and cardiovascular disease. The series focuses on the impacts of global warming, air pollution and exposure to wildfire smoke on cardiovascular health and highlight "lesser-known drivers of heart disease" including exposure to toxic chemicals and soil, noise and light pollution.

"Both epidemiologic evidence and mechanistic evidence link all these pollution forms to increased cardiovascular morbidity and mortality," write Mark R. Miller, PhD, et al. "In reviewing these topics, we hope to highlight the significance of environmental stresses to the global burden of disease and to mobilize the cardiovascular community to advocate for interventions to reduce pollution emissions and slow the progress of global warming."

Part 1 of the series focuses primarily on global warming and air pollution, with added attention paid to the health impacts caused by the increasing number of wildfires worldwide. The authors highlight the increased risk of cardiovascular morbidity and mortality associated with both global warming and air pollution and note the important role the medical community, including cardiologists and other clinicians, can play in providing practical advice about environmental risk to patients.

"Although global warming and air pollution are aligned in many respects, perhaps the single most critical factor linking them is that both are major public health emergencies," the authors write. "Indeed, both global warming and air pollution may ultimately prove to be the greatest global crises hitherto faced by humankind. Reducing either stressor will likely have benefits on the other; however, a concerted effort on both is critical to future human and planetary health."

Part 2 of the series explores the increasing evidence suggesting that water, soil, noise and light pollution increase cardiovascular morbidity and mortality. The authors note the diverse mechanisms linking these sources of pollution to cardiovascular disease, "making mitigation efforts challenging," especially in vulnerable populations, including indigenous communities and lower-income communities/countries.

However, they also suggest that evolving methods to track these sources of pollution like pollution-related clinical biomarkers and screening tools, may point to new strategies. Looking ahead, "the identification and management of pollution exposure in individual patients will be an area of increasing clinical relevance," they write. Additionally, they call on the cardiology community, including cardiovascular health foundations, to engage with local and public health bodies and to advocate for political change both in the U.S. and globally.

Clinical Topics: Cardiovascular Care Team

Keywords: ACC International, Climate Change, Global Burden of Disease, Global Warming, Air Pollution

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