Expert Panel Warns Heart Patients and Lawmakers of Air Pollution Risks

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In a statement from the American Heart Association, patients with heart disease are warned of the risks of increased exposure to air pollution. Patients with heart disease should minimize time spent in traffic, and stay indoors when air pollution from particulate matter is especially high. The panel also says healthy individuals should take action to protect from the hazards of air pollution.

Individuals with existing heart disease may be especially susceptible to heart attack, stroke, irregular heartbeat, and death from the effects of fine particulate matter that comes from burning fossil fuel, industry, traffic, and power generation. The statement from the American Heart Association warns it is especially important for individuals with known heart diseases, such as heart failure or coronary artery disease, and perhaps those with diabetes remain especially cautious to protect themselves from the health risks of air pollution, even for short periods of time.

Robert D. Brook, M.D., lead author of the statement says, “Particulate matter appears to directly increase risk by triggering events in susceptible individuals within hours to days of an increased level of exposure, even among those who otherwise may have been healthy for years.”Other sources of air pollution that can lead to cardiovascular events from exposure to particulate matter, specificaly PM2.5, include forest fires, cooking stoves, burning, heating, and biomass burning.

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The panel suggests that exposure to air pollution should now be considered a “modifiable factor” that contributes to heart disease and death. The panel found there is “strong evidence” that air pollution can lead to heart disease, and a “moderate, yet growing link” that particulate matter exposure from PM2.5 can lead to stroke and heart failure. The statement is an update from 2004 that showed a causal relationship between air pollution and heart disease.

Dr. Brook, a cardiovascular medicine specialist and associate professor in the Department of Internal Medicine at the University of Michigan in Ann Arbor, says patients with heart disease should also do everything possible to modify risk factors through smoking cessation, blood pressure, and cholesterol and diabetes control. Exposure to air pollution can set off a series of events that lead to inflammation and worsening heart disease, stroke, irregular heart rhythm and death.

Dr. Brooks says, “It’s possible that certain very small particles, or chemicals that travel with them, may reach the circulation and cause direct harm”. Particles in the environment that cause air pollution may irritate nerves in the respiratory tract that in turn increases the risk of heart attack, hypertension, and irregular heart rhythms. The panel says physicians should educate patients about the risks of air pollution so they can limit outdoor activity and decrease exposure to PM2.5 particulate matter.

Dr. Brooks says, “These studies also indicate that there is no ‘safe’ level of PM2.5 exposure.” In a joint effort, the American Heart Association and the Environmental Protection Agency plan to brief our lawmakers about the dangers of air pollution especially for heart patients, elders , and perhaps individuals with diabetes, in hopes of affecting change.

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