Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio; Case Cardiovascular Research Institute, Case Western Reserve University, Cleveland, Ohio.
Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio.
J Am Coll Cardiol. 2018 Oct 23;72(17):2054-2070. doi: 10.1016/j.jacc.2018.07.099.
Fine particulate matter <2.5 μm (PM) air pollution is the most important environmental risk factor contributing to global cardiovascular (CV) mortality and disability. Short-term elevations in PM increase the relative risk of acute CV events by 1% to 3% within a few days. Longer-term exposures over several years increase this risk by a larger magnitude (∼10%), which is partially attributable to the development of cardiometabolic conditions (e.g., hypertension and diabetes mellitus). As such, ambient PM poses a major threat to global public health. In this review, the authors provide an overview of air pollution and health, including assessment of exposure, impact on CV outcomes, mechanistic underpinnings, and impact of air pollution reduction strategies to mitigate CV risk. The review concludes with future challenges, including the inextricable link between air pollution and climate change, and calls for large-scale trials to allow the promulgation of formal evidence-based recommendations to lower air pollution-induced health risks.
细颗粒物（PM）空气污染是导致全球心血管（CV）死亡率和残疾的最重要环境风险因素。在几天内，PM 的短期升高会使急性 CV 事件的相对风险增加 1%至 3%。而在几年的时间里，长期暴露会使这种风险增加更大的幅度（约 10%），这部分归因于代谢性心血管疾病（如高血压和糖尿病）的发展。因此，环境 PM 对全球公共健康构成了重大威胁。在这篇综述中，作者概述了空气污染与健康，包括对暴露的评估、对 CV 结局的影响、潜在机制以及空气污染减排策略对降低 CV 风险的影响。综述最后讨论了未来的挑战，包括空气污染与气候变化之间的不可分割的联系，并呼吁开展大规模试验，以便颁布正式的循证建议，降低空气污染引起的健康风险。
