Goldsborough Earl, Gopal Medha, McEvoy John William, Blumenthal Roger S, Jacobsen Alan P
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Saint George's University School of Medicine, University Centre Grenada, West Indies, Grenada.
Am Heart J Plus. 2022 Dec 6;25:100231. doi: 10.1016/j.ahjo.2022.100231. eCollection 2023 Jan.
Pollution is a leading cause of premature morbidity and mortality and an important risk factor for cardiovascular disease. Convincing data predict increased rates of cardiovascular morbidity and mortality with current and projected pollution burden trends. Multiple classes of pollutants - including criteria air pollutants, secondhand smoke, toxic steel pollutants, and manufactured chemical pollutants - are associated with varied cardiovascular disease risk profiles. To reduce the future risk of cardiovascular disease from anthropogenic pollution, mitigation strategies, both at the individual level and population level, must be thoughtfully and intentionally employed. The literature supporting individual level interventions to protect against cardiovascular disease is growing but lacks large clinical trials. Population level interventions are crucial to larger societal change and rely upon policy and governmental support. While these mitigation strategies can play a major role in maintaining the health of individuals, planetary health - the impact on human health because of anthropogenic perturbation of natural ecosystems - must also be acknowledged. Future research is needed to further delineate the planetary health implications of current and projected pollutant burden as well as the mitigation strategies employed to attenuate future pollutant burden.
污染是过早发病和死亡的主要原因，也是心血管疾病的重要风险因素。有说服力的数据表明，随着当前和预计的污染负担趋势，心血管疾病的发病率和死亡率将会上升。多种类别的污染物——包括标准空气污染物、二手烟、有毒金属污染物和人造化学污染物——与不同的心血管疾病风险状况相关。为了降低人为污染导致的未来心血管疾病风险，必须精心且有意地采用个体层面和群体层面的缓解策略。支持个体层面预防心血管疾病干预措施的文献在不断增加，但缺乏大型临床试验。群体层面的干预措施对于更大范围的社会变革至关重要，且依赖政策和政府支持。虽然这些缓解策略在维护个体健康方面可发挥重要作用，但也必须认识到地球健康——即由于人类活动对自然生态系统的扰动而对人类健康产生的影响。未来需要开展研究，以进一步阐明当前和预计的污染物负担对地球健康的影响，以及为减轻未来污染物负担而采用的缓解策略。
