Lee Kuan Ken, Miller Mark R, Shah Anoop S V
BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
J Stroke. 2018 Jan;20(1):2-11. doi: 10.5853/jos.2017.02894. Epub 2018 Jan 31.
The adverse health effects of air pollution have long been recognised; however, there is less awareness that the majority of the morbidity and mortality caused by air pollution is due to its effects on the cardiovascular system. Evidence from epidemiological studies have demonstrated a strong association between air pollution and cardiovascular diseases including stroke. Although the relative risk is small at an individual level, the ubiquitous nature of exposure to air pollution means that the absolute risk at a population level is on a par with "traditional" risk factors for cardiovascular disease. Of particular concern are findings that the strength of this association is stronger in low and middle income countries where air pollution is projected to rise as a result of rapid industrialisation. The underlying biological mechanisms through which air pollutants exert their effect on the vasculature are still an area of intense discussion. A greater understanding of the effect size and mechanisms is necessary to develop effective strategies at individual and policy levels to mitigate the adverse cardiovascular effects of air pollution.
空气污染对健康的不良影响早已为人所知；然而，人们较少意识到，空气污染导致的大多数发病和死亡是由于其对心血管系统的影响。流行病学研究的证据表明，空气污染与包括中风在内的心血管疾病之间存在密切关联。虽然在个体层面相对风险较小，但空气污染暴露的普遍存在意味着在人群层面的绝对风险与心血管疾病的“传统”风险因素相当。特别令人担忧的是，有研究发现，在低收入和中等收入国家，这种关联更为强烈，而由于快速工业化，这些国家的空气污染预计还会加剧。空气污染物对脉管系统产生影响的潜在生物学机制仍是一个激烈讨论的领域。更深入了解影响程度和机制，对于在个体和政策层面制定有效策略以减轻空气污染对心血管的不良影响至关重要。
