RT Book, Section A1 Hadley, Michael B. A1 Rajagopalan, Sanjay A2 Fuster, Valentin A2 Narula, Jagat A2 Vaishnava, Prashant A2 Leon, Martin B. A2 Callans, David J. A2 Rumsfeld, John A2 Poppas, Athena SR Print(0) ID 1191370211 T1 Air Pollution and Cardiovascular Disease T2 Fuster and Hurst's The Heart, 15e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264257560 LK accesscardiology.mhmedical.com/content.aspx?aid=1191370211 RD 2023/02/07 AB Chapter SummaryThis chapter discusses the effects of air pollution on cardiovascular risk factors and outcomes. The vast majority (>90%) of the world’s population is exposed to ambient fine particulate matter air pollution that exceeds World Health Organization guidelines. Almost 5 million deaths (8.7% of global mortality) were attributed to air pollution in 2017, and >50% of air pollution deaths are due to cardiovascular disease. Indeed, at least one in nine cardiovascular deaths are attributed to air pollution. Fine particulate matter is the component of air pollution most linked to adverse cardiovascular effects; the particles have diameter <2.5 μm and are largely derived from fossil-fuel combustion from power generation, industrial emissions, motorized vehicles, and household burning of solid fuel. Inhaled fine particulate matter triggers multiple interdependent initiating mechanisms (see Fuster and Hurst’s Central Illustration), with subsequent effector pathways leading to development and exacerbation of cardiovascular risk factors such as elevated blood pressure, elevated blood glucose, atherosclerosis, and myocardial remodeling. A large body of evidence links air pollution exposure with cardiovascular mortality, acute coronary syndrome, stroke, heart failure, and arrhythmias. Cardiovascular risk from air pollution is modifiable at the individual and population levels. Various strategies for mitigating the harmful effects of air pollution are discussed.