Live or work in a congested area? You may need to take extra precautions to protect your heart health. Evidence shows that air pollution is a risk factor for heart disease and stroke. In fact, there is a measurable increase in deaths and hospitalizations when city smog levels are high.

Air pollution is a mixture of gasses (such as carbon dioxide and carbon monoxide), liquids and particulate matter, a mixture of solid particles and liquid droplets (usually related to fuel combustion). These tiny particles can easily enter the body and have a high surface-to-mass ratio, which may make them even more toxic. The particles may pass directly into the circulatory system where they are disseminated throughout the body.

Air Pollution as a Heart Attack Trigger

The elderly and those who already have heart disease are at particular risk from air pollution. For example, pollutants can play a role in causing plaque to rupture and triggering a heart attack in individuals who already have fatty deposits on the lining of their arteries.

Pollution is not just an outdoor phenomenon. According to the American Heart Association (AHA), secondhand smoke is the biggest contributor to indoor particulate matter when a smoker is present, and there is clear evidence of an association between secondhand smoke and cardiovascular disease. According to William Tansey III, MD, New Jersey-based cardiologist, secondhand smoke is one of the nation's most prevalent threats to heart health.

Air pollution can trigger a heart attack, stroke, or irregular heart rhythm. Individuals at an increased risk include those who have or have had:

  • Heart attack
  • Angina
  • Bypass surgery
  • Angioplasty
  • Stroke
  • Blockages in the neck or leg arteries
  • Heart failure
  • Diabetes
  • Chronic obstructive lung disease

According to the AHA's official statement about air pollution and heart disease, "an increase in relative risk for cardiovascular disease due to air pollution for an individual is small compared with the impact of the established cardiovascular risk factors. However, because of the enormous number of people affected, even conservative risk estimates translate into a substantial increase in total mortality within the population."

Almost 20 percent of all U.S. counties with air-quality monitoring systems are not meeting national air quality standards. Furthermore, the AHA says there is no threshold under which particulate matter concentrations are safe.

How to Protect Yourself From Air Pollution

While moving may not be an option, there are ways you can reduce your exposure to pollution and reduce your risk for cardiovascular events. They include:

  • Avoid or limit your time in areas where air pollution tends to build up, such as near busy roads and in urban or industrial areas.
  • Avoid smoke from wood burning stoves, fireplaces, burning vegetation and forest fires.
  • If you smoke cigarettes, stop.

Also, pay attention to published Air Quality Indexes (AQI), which provide information on local air quality and safety. Find daily reports at When the AQI is high (over 101 for sensitive individuals and 151 for everyone else), limit your outside activities and exertion or move indoors.

William Tansey III, MD, FACC, reviewed this article.



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