Exposure to air pollutants, road traffic noise may increase risk for HF
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Long-term exposure to fine particulate matter, nitrogen dioxide and noisy road traffic may induce risk factors associated with disease progression of HF, according to research published in the Journal of the American Heart Association.
Background on pollutants and CVD risk
“Air pollution has been recognized as a risk factor for ischemic and coronary cardiovascular disease, whereas evidence on HF is more limited and novel,” Youn-Hee Lim, PhD, assistant professor in the section of environmental health at the University of Copenhagen, Denmark, and colleagues wrote.
Air pollution may impact factors associated with HF, including oxidative stress, inflammation, autonomic nervous system imbalance and endothelial function, according to the study.
“Road traffic noise is an increasingly recognized environmental stressor that can lead to inflammatory responses and oxidative stress as well as cause annoyance and sleep disturbance. Road traffic noise has been linked to ischemic heart disease, whereas only four studies considered HF,” the researchers wrote. “Here we examined the associations of long-term exposure to air pollution and road traffic noise, independently and jointly, with incident HF, and considered possible effect modification by lifestyle and comorbidity.”
For this analysis, researchers included 22,189 female nurses from the Danish Nurse Cohort, of whom 484 developed HF during a mean follow-up of 18.1 person-years. Researchers estimated the mean particulate matter with a diameter less than 2.5 m (PM2.5) and nitrogen dioxide (NO2) since 1990 and road traffic noise since 1970 based on participants’ residences.
Air pollution, traffic noise and HF risk
According to the study, 3-year mean of NO2 was moderately associated with PM2.5 (Spearman’s rank correlation coefficient = 0.58) and noise from road traffic (Spearman rank correlation = 0.62); however, correlation between PM2.5 and road noise was low (Spearman rank correlation = 0.38).
According to the study, nurses who developed HF were more likely to be older (60.4 vs. 52.4 years), more likely to have a history of hypertension (30% vs. 12%) or diabetes (5% vs. 1.1%) and less likely to use oral contraceptives at baseline (38.8% vs. 61.4%) compared with those who did not develop HF.
Researchers observed elevated risk for HF associated with PM2.5 (HR for every 5.1 g/m3 increase = 1.17; 95% CI, 1.01-1.36), NO2 (HR for every 8.6 g/m3 increase = 1.1; 95% CI, 0.99-1.22) and road traffic noise (HR for every 9.3 dB increase = 1.12; 95% CI, 0.99-1.26).
Moreover, there was no effect modification of NO2 and road traffic noise on the association of HF with PM2.5; however, researchers did observe elevated risk for HF among individuals who were exposed to high levels of all three pollutants (HR for high exposure to one or two pollutants = 1.15; 95% CI, 0.94-1.41; HR for high exposure to all three = 1.43; 95% CI, 1.02-1.99) compared with low exposure to all three.
“We were surprised by how two environmental factors — air pollution and road traffic noise — interacted,” Lim said in a press release. “Air pollution was a stronger contributor to heart failure incidence compared to road traffic noise; however, the women exposed to both high levels of air pollution and road traffic noise showed the highest increase in heart failure risk. In addition, about 12% of the total study participants had hypertension at enrollment of the study. However, 30% of the nurses with heart failure incidence had a previous history of hypertension, and they were the most susceptible population to air pollution exposure.”
In other findings, former smokers and nurses with hypertension showed the strongest associations with PM2.5 (P for effect modification < .05).
“To minimize the impact of these exposures, broad public tactics such as emissions control measures should be implemented. Strategies like smoking cessation and blood pressure control must be encouraged to help reduce individual risk,” Lim said in the release.
Reference:
- Years of exposure to air pollution and road traffic noise may raise heart failure risk. newsroom.heart.org/news/years-of-exposure-to-air-pollution-and-road-traffic-noise-may-raise-heart-failure-risk. Published Oct. 6, 2021. Accessed Oct. 6, 2021.
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