European Society of Cardiology adds air pollution to heart disease guidance

For the first time, the European Society of Cardiology (ESC) has included in its guidelines the impact of air pollution on patients with chronic heart problems.

The ESC is an independent, nonprofit organisation aiming to tackle cardiovascular disease and each year they publish updated guidelines for doctors and cardiologists in the European Heart Journal, and on the ESC website.

Alongside several risk factors for heart disease, including poor diet, smoking and a lack of exercise, they say air pollution is now recognised to be one of the 10 leading risk factors for global mortality and exposure to pollutants increases the risk of heart attacks as well as hospitalisation and death from heart failure or strokes.

It says that patients with heart disease should avoid areas with lots of traffic and recommends that patients utilise HEPA air pollution filters to reduce indoor pollutants and wear respirator face masks in areas that are heavily polluted.

It says all patients should be advised about these risks and that doctors should support any policies and regulations that reduce air pollution.

Professor Juhani Knuuti, chairperson of the guidelines Task Force and director of the Turku PET Centre, Finland said: ‘Air pollution and environmental noise increase the risk of heart attack and stroke, so policies and regulations are needed to minimise both.

‘Patients with chronic coronary syndromes should avoid areas with heavy traffic congestion and may consider wearing a respirator face mask. Air purifiers with high-efficiency particulate air filters can be used to reduce indoor pollution.’

In related news, a study last week suggested that hospitals in cities that have high levels of air pollution report higher rates of treatment for blocked arteries.

For the study, which was published in the European Society of Cardiology, researchers from Krakow, Poland, compared five cities in the country where the annual average PM10 concentration was over 50μg/m3 with six cities where levels were around half this.

They then enrolled 5,648 patients from the ‘unpolluted’ cities and 10,239 patients from polluted cities with all patients having stents inserted to open arteries that had been blocked due to acute coronary syndromes such as heart attacks or unstable angina.

Dates of stent procedures (PCIs) were matched with air quality on the same day during a 52-week period. Analyses were also performed to compare winter versus non-winter weeks because pollution levels rise during winter in Poland.

The research found that patients in cities with clean air were more sensitive to pollution rises, with each 1 μg/m3 increase in PM10 concentration linked to 0.22 additional procedures per week.

Meanwhile, in polluted cities, the same rise in PM10 was linked with just 0.18 additional PCIs per week.

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