بار بیماری های قلبی عروقی منتسب به آلودگی هوا: یک بررسی سیستماتیک

Title

  Burden of cardiovascular disease attributed to air pollution: a systematic review

Author(s)

Amir Hossein Khoshakhlagh, Mahdiyeh Mohammadzadeh, Agnieszka Gruszecka‑Kosowska and Evangelos Oikonomou

Published

03 May 2024

Journal

BMC Public Health

Abstract

Background: Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution

is the biggest environmental threat to public health worldwide. It is considered a potentially modifable environ‐

mental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The

present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pol‐

lution, namely prevalence, hospitalization, disability, mortality, and cost characteristics.

Methods: A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify stud‐

ies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor

air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality

of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the New‐

castle–Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories

A and B were included in the study.

Results: Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defned as eligible

in the present systematic review. The results of these investigations supported that chronic exposure to various

concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs

attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated

closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016–2019

has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014.

Conclusion: Ambient air pollution is an underestimated but signifcant and modifable contributor to CVDs burden

and public health costs. This should not only be considered an environmental problem but also as an important

risk factor for a signifcant increase in CVD cases and mortality. The fndings of the systematic review highlighted

the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs

in human society.

Article Address

doi.org/10.1186/s12889-024-18591-x