Hahad Omar, Sagheer Usman, Nasir Khurram, Kuntic Marin, Daiber Andreas, Navas-Acien Ana, Chen Kai, Rajagopalan Sanjay, Al-Kindi Sadeer
Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
German Centre for CV Research (DZHK), partner site Rhine-Main, Mainz, Germany.
Curr Atheroscler Rep. 2025 Jan 22;27(1):28. doi: 10.1007/s11883-025-01274-2.
The exposome refers to the total environmental exposures a person encounters throughout life, and its relationship with human health is increasingly studied. This non-systematic review focuses on recent research investigating the effects of environmental factors-such as air pollution, noise, greenspace, neighborhood walkability, and metallic pollutants-on atherosclerosis, a major cause of cardiovascular disease.
Studies show that long-term exposure to airborne particulate matter can impair endothelial function and elevate adhesion molecule levels, leading to vascular damage. Nighttime traffic noise also negatively impacts endothelial health. On the other hand, living in areas with more greenspace and better neighborhood walkability is linked to reduced arterial stiffness, suggesting protective cardiovascular effects. Mechanisms involved include oxidative stress, inflammation, and sympathetic activation from air pollution and noise. Metallic pollutants, including lead, cadmium, and arsenic, are linked to early signs of atherosclerosis through mechanisms involving oxidative stress. However, the effects of specific pollutants and their interactions remain incompletely understood. There is a growing need to mitigate harmful environmental exposures, such as air pollution and noise, while promoting beneficial ones like greenspace, to improve cardiovascular health. Emerging technologies like remote sensing and artificial intelligence can help further our understanding of how the exposome influences cardiovascular outcomes. More research is necessary to clarify the impact of specific pollutants as well as their interactions and how they contribute to atherosclerosis.
暴露组是指一个人一生中所接触的全部环境暴露因素，其与人类健康的关系正受到越来越多的研究。本非系统性综述聚焦于近期有关环境因素（如空气污染、噪音、绿地、邻里步行便利性和金属污染物）对动脉粥样硬化（心血管疾病的主要病因）影响的研究。
研究表明，长期暴露于空气中的颗粒物会损害内皮功能并提高黏附分子水平，从而导致血管损伤。夜间交通噪音也会对内皮健康产生负面影响。另一方面，生活在绿地较多且邻里步行便利性较好的地区与动脉僵硬度降低有关，提示对心血管有保护作用。其中涉及的机制包括空气污染和噪音引起的氧化应激、炎症和交感神经激活。包括铅、镉和砷在内的金属污染物通过涉及氧化应激的机制与动脉粥样硬化的早期迹象有关。然而，特定污染物的影响及其相互作用仍未完全了解。越来越有必要减少有害的环境暴露，如空气污染和噪音，同时促进有益的暴露，如绿地，以改善心血管健康。遥感和人工智能等新兴技术有助于进一步了解暴露组如何影响心血管结局。有必要开展更多研究，以阐明特定污染物的影响及其相互作用，以及它们如何导致动脉粥样硬化。
