‘Urgent action’ needed to stem heart disease risk related to climate change
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Key takeaways:
- A review of nearly 500 studies found that environmental stressors worsening with climate change are linked to heart disease risk.
- The authors called for urgent action to mitigate the trend.
In a review of nearly 500 observational studies, researchers determined that certain environmental stressors are associated with heart disease and are getting worse due to climate change.
“Climate change is already adversely affecting cardiovascular health in the U.S. and worldwide,” Dhruv S. Kazi, MD, MSc, MS, FAHA, head of health economics and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center, said in a press release. “Urgent action is needed to mitigate climate change-related cardiovascular risk, particularly among our most vulnerable populations.”
Kazi and colleagues analyzed 492 observational studies evaluating the relationship between environmental exposures and CV mortality, including 182 on extreme temperature, 210 on ground-level ozone, 45 on wildfire smoke and 63 on extreme weather events. The studies were conducted in 30 high-income countries, 17 middle-income countries and one low-income country.
The researchers found the strength of evidence was sufficient for the following topics: extreme temperature; ground-level ozone; tropical storms, hurricanes and cyclones; and dust storms. They found it was limited for wildfire smoke and inadequate for drought and mudslides.
Exposure to extreme temperature was associated with CV morbidity and mortality, and the association was strongest at the most extreme temperatures and for exposure at longer durations, according to the researchers.
The CV risk from extreme temperatures was exacerbated by exposure to excess ground-level ozone and vice versa, Kazi and colleagues wrote.
Extreme weather events such as hurricanes were linked to elevated risk for CV events that persisted for months after the event, according to the researchers.
The evidence on wildfire smoke was mixed, with some studies finding no association between it and CV events and others finding small increases in risk for CV mortality, ischemic heart disease hospitalization and out-of-hospital cardiac arrest, Kazi and colleagues wrote.
“Given how many Americans are now being exposed to wildfire smoke every year — as was the case of wildfire smoke from Canadian fires affecting New York City last summer — further studies to accurately quantify this risk are urgently needed,” Kazi said in the release.
The link between environmental exposures and CV mortality was strongest in individuals with older age, those from traditionally underrepresented backgrounds and those from lower-wealth communities, the researchers wrote.
“Climate change is already affecting our cardiovascular health; exposure to extreme heat can adversely affect heart rate and blood pressure; exposure to ozone or wildfire smog can trigger systemic inflammation; living through a natural disaster can cause psychological distress; and hurricanes and floods may disrupt health care delivery through power outages and supply chain disruptions; and in the long term, the changing climate is projected to produce declines in agricultural productivity and the nutritional quality of the food supply, which could also compromise cardiovascular health,” Kazi said in the release. “We know that these pathways have the potential to undermine the cardiovascular health of the population, but the magnitude of the impact, and which populations will be particularly susceptible, need further study.”
Reference:
- Climate change-related disturbances linked to worse cardiovascular health, researchers show. https://www.newswise.com/articles/climate-change-related-disturbances-linked-to-worse-cardiovascular-health-researchers-show. Published June 12, 2024. Accessed June 12, 2024.
Perspective
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This paper is a review of other studies that have looked at the association between various climate change-related extreme weather phenomena, including extreme heat and increases in air pollution related to wildfires, and CV health. They find that many of these phenomena are associated with worse CV health and an increased risk for dying from CVD. This raises the concern that with a continued increase in extreme weather events, the burden of climate change-related CV adverse health events is likely to increase. It is also important to note that the burden of this falls disproportionately on lower- and middle-income countries globally and on more socioeconomically disadvantaged populations in industrialized countries.
This study did not specially explore actions to mitigate such risk, and this is an area that is largely unstudied. A lot of the measures that may be useful are those that need to be done at the community or country level. This includes increasing tree cover, which has been suggested as a strategy to reduce the risk for heat-related deaths. Some studies have looked at whether heat action plans or air quality alerts can mitigate the health impacts of extreme heat and poor air quality, respectively. Such strategies may play a role for improving CV health as well. On an individual level, there are some studies suggesting that medications such as statins can mitigate the impact of extreme heat on CV health. Finally, concrete global and national efforts to reduce greenhouse gas emissions is a crucial component of potentially slowing the increase of these extreme weather events.
An important knowledge gap is how different strategies, whether at the community or individual level, can reduce the impact of extreme weather events on CV health. This is something that urgently needs to be studied.
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