Air pollution, climate, and heart disease.

T wo decades of research have shown that air pollution can trigger heart attacks, strokes, and irregular heart rhythms, particularly in people already at risk for these conditions. Several reviews of these studies, including 2 American Heart Association scientific statements, describe the scientific findings and conclude that air pollution poses a risk to heart health. You can help protect your health and the health of your family, neighbors, and community from risk caused by air pollution, including the risk to your cardio-vascular health. The Environmental Protection Agency (EPA), American Heart Association, American Stroke Association, and American College of Cardiology have published a concise leaflet on " Heart Disease, Stroke and Outdoor Air Pollution " that is available online (www.epa.gov/airnow/ heart_flyer-1-28-10-final.pdf). 5 This article provides advice for patients based partially on this leaflet and the EPA website http://airnow. gov/. 6 General advice on air pollution and the heart is also available on the EPA website Air pollution is a mixture of gases and particles that come from manmade and natural sources. For heart disease and stroke, very small particles that go down into the airways seem to be the most important form of air pollution for triggering these events, particularly in those at high risk. These particles, measured and reported by the EPA as PM 2.5 , come from cars and trucks, power plants, industrial boilers, other industrial sources, and wildfires. Globally, cigarette smoking and wood-or biomass-burning stoves used for cooking 8 and heating are major sources of indoor particle pollution. Ground-level ozone, known for years to worsen lung disease, may also trigger heart attacks and strokes in susceptible people. It is formed when pollutant gases emitted by cars and trucks, power plants, industrial boilers, refineries, chemical plants, and other sources react chemically in the presence of sunlight and heat. For most people, air pollution poses only a small risk as a trigger for heart attacks, strokes, or irregular heart rhythm. However, some people are at higher risk, including those who have had a heart attack or angioplasty or those who have angina, heart failure, some types of heart rhythm problems, or diabetes mellitus. You may also be at greater risk from air pollution if you have known risk factors for heart disease: if you smoke cigarettes, if you have high blood pressure or high blood cholesterol, if you have a family history of stroke or early heart disease (father or …