Urbanization and declining air quality: clinical aspects of cardiovascular impact
Farida Azizova , Center for Professional Development of Medical Workers, Tashkent, UzbekistanAbstract
Rapid urbanization has significantly contributed to deteriorating air quality across global cities. Increasing levels of air pollutants, particularly fine particulate matter (PM2.5), nitrogen dioxide (NO₂), and ozone (O₃), are linked to adverse cardiovascular outcomes. This article explores the clinical implications of declining air quality due to urbanization, reviewing evidence from epidemiological and clinical studies and analyzing the mechanisms through which air pollution exacerbates cardiovascular disease. The findings emphasize the urgent need for integrative public health policies and clinical interventions to mitigate these risks.
Keywords
Urbanization, Air Pollution, Cardiovascular Disease (CVD)
References
Bell, M. L., Ebisu, K., Leaderer, B. P., Gent, J. F., Lee, H. J., Koutrakis, P., & Peng, R. D. (2014). Associations of PM2.5 constituents and sources with hospital admissions: analysis of four counties in Connecticut and Massachusetts (USA) for persons ≥65 years of age. Environmental Health Perspectives, 122(2), 138–144.
Brauer, M., Freedman, G., Frostad, J., et al. (2016). Ambient air pollution exposure estimation for the Global Burden of Disease 2013. Environmental Science & Technology, 50(1), 79–88.
Brook, R. D., Rajagopalan, S., Pope, C. A. III, et al. (2010). Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation, 121(21), 2331–2378.
Fuks, K. B., Weinmayr, G., Basagaña, X., et al. (2014). Long-term exposure to ambient air pollution and traffic noise and incident hypertension in seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). European Heart Journal, 38(13), 983–990.
Kaufman, J. D., Adar, S. D., Allen, R. W., et al. (2016). Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the MESA Air study): A longitudinal cohort study. The Lancet, 388(10045), 696–704.
Münzel, T., Hahad, O., Kuntic, M., et al. (2017). Effects of air pollution on the cardiovascular system. European Heart Journal, 38(8), 555–561. https://doi.org/10.1093/eurheartj/ehw139
Newby, D. E., Mannucci, P. M., Tell, G. S., et al. (2015). Expert position paper on air pollution and cardiovascular disease. European Heart Journal, 36(2), 83–93b.
Page, M.J., McKenzie, J.E., Bossuyt, P.M., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pope, C. A. III, Turner, M. C., Burnett, R. T., et al. (2016). Relationships between fine particulate air pollution, cardiometabolic disorders, and cardiovascular mortality. Circulation Research, 119(11), 1204–1215.
Rajagopalan, S., Al-Kindi, S.G., & Brook, R.D. (2018). Air pollution and cardiovascular disease: JACC state-of-the-art review. Journal of the American College of Cardiology, 72(17), 2054–2070. https://doi.org/10.1016/j.jacc.2018.07.099
Shah, A. S. V., Lee, K. K., McAllister, D. A., et al. (2013). Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ, 346, f1295.
Wilker, E. H., Mittleman, M. A., Coull, B. A., et al. (2013). Long-term exposure to ambient air pollution and subclinical measures of cardiovascular disease: The Framingham Heart Study. Environmental Health Perspectives, 121(5), 639–645.
World Health Organization (2021). WHO global air quality guidelines: Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide.
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