1932

Abstract

Inhalation of fine particulate matter (PM), produced by the combustion of fossil fuels, is an important risk factor for cardiovascular disease. Exposure to PM has been linked to increases in blood pressure, thrombosis, and insulin resistance. It also induces vascular injury and accelerates atherogenesis. Results from animal models corroborate epidemiological evidence and suggest that the cardiovascular effects of PM may be attributable, in part, to oxidative stress, inflammation, and the activation of the autonomic nervous system. Although the underlying mechanisms remain unclear, there is robust evidence that long-term exposure to PM is associated with premature mortality due to heart failure, stoke, and ischemic heart disease.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-042220-011549
2022-01-27
2024-06-19
Loading full text...

Full text loading...

/deliver/fulltext/med/73/1/annurev-med-042220-011549.html?itemId=/content/journals/10.1146/annurev-med-042220-011549&mimeType=html&fmt=ahah

Literature Cited

  1. 1. 
    Jacobson MZ. 2012. Air Pollution and Global Warming: History, Science, and Solutions Cambridge, UK: Cambridge Univ. Press
    [Google Scholar]
  2. 2. 
    Helfand WH, Lazarus J, Theerman P 2001. Donora, Pennsylvania: an environmental disaster of the 20th century. Am. J. Public Health 91:553
    [Google Scholar]
  3. 3. 
    Bell ML, Davis DL. 2001. Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. Environ. Health Perspect. 109:Suppl. 3389–94
    [Google Scholar]
  4. 4. 
    Rajagopalan S, Al-Kindi SG, Brook RD. 2018. Air pollution and cardiovascular disease: JACC state-of-the-art review. J. Am. Coll. Cardiol. 72:2054–70
    [Google Scholar]
  5. 5. 
    Bhatnagar A. 2006. Environmental cardiology: studying mechanistic links between pollution and heart disease. Circ. Res. 99:692–705
    [Google Scholar]
  6. 6. 
    Brook RD, Rajagopalan S, Pope CA 3rd et al. 2010. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121:2331–78
    [Google Scholar]
  7. 7. 
    Al-Kindi SG, Brook RD, Biswal S, Rajagopalan S 2020. Environmental determinants of cardiovascular disease: lessons learned from air pollution. Nat. Rev. Cardiol. 17:656–72
    [Google Scholar]
  8. 8. 
    Cosselman KE, Navas-Acien A, Kaufman JD. 2015. Environmental factors in cardiovascular disease. Nat. Rev. Cardiol. 12:627–42
    [Google Scholar]
  9. 9. 
    Kaufman JD, Elkind MSV, Bhatnagar A et al. 2020. Guidance to reduce the cardiovascular burden of ambient air pollutants: a policy statement from the American Heart Association. Circulation 142:e432–47
    [Google Scholar]
  10. 10. 
    Bhatnagar A. 2016. Cardiovascular perspective of the promises and perils of e-cigarettes. Circ. Res. 118:1872–75
    [Google Scholar]
  11. 11. 
    Bhatnagar A. 2004. Cardiovascular pathophysiology of environmental pollutants. Am. J. Physiol. Heart Circ. Physiol. 286:H479–85
    [Google Scholar]
  12. 12. 
    Miller MR, Raftis JB, Langrish JP et al. 2017. Inhaled nanoparticles accumulate at sites of vascular disease. ACS Nano 11:4542–52
    [Google Scholar]
  13. 13. 
    Wiebert P, Sanchez-Crespo A, Seitz J et al. 2006. Negligible clearance of ultrafine particles retained in healthy and affected human lungs. Eur. Respir. J. 28:286–90
    [Google Scholar]
  14. 14. 
    Palko HA, Fung JY, Louie AY. 2010. Positron emission tomography: a novel technique for investigating the biodistribution and transport of nanoparticles. Inhal. Toxicol. 22:657–88
    [Google Scholar]
  15. 15. 
    Maher BA, Ahmed IA, Karloukovski V et al. 2016. Magnetite pollution nanoparticles in the human brain. PNAS 113:10797–801
    [Google Scholar]
  16. 16. 
    Haberzettl P, O'Toole TE, Bhatnagar A, Conklin DJ 2016. Exposure to fine particulate air pollution causes vascular insulin resistance by inducing pulmonary oxidative stress. Environ. Health Perspect. 124:1830–39
    [Google Scholar]
  17. 17. 
    Haberzettl P, Conklin DJ, Abplanalp WT et al. 2018. Inhalation of fine particulate matter impairs endothelial progenitor cell function via pulmonary oxidative stress. Arterioscler. Thromb. Vasc. Biol. 38:131–42
    [Google Scholar]
  18. 18. 
    Wu YF, Li ZY, Dong LL et al. 2020. Inactivation of MTOR promotes autophagy-mediated epithelial injury in particulate matter–induced airway inflammation. Autophagy 16:435–50
    [Google Scholar]
  19. 19. 
    Roy A, Gong J, Thomas DC et al. 2014. The cardiopulmonary effects of ambient air pollution and mechanistic pathways: a comparative hierarchical pathway analysis. PLOS ONE 9:e114913
    [Google Scholar]
  20. 20. 
    Zindel J, Kubes P. 2020. DAMPs, PAMPs, and LAMPs in immunity and sterile inflammation. Annu. Rev. Pathol. Mech. Dis. 15:493–518
    [Google Scholar]
  21. 21. 
    Rhoden CR, Lawrence J, Godleski JJ, Gonzalez-Flecha B. 2004. N-Acetylcysteine prevents lung inflammation after short-term inhalation exposure to concentrated ambient particles. Toxicol. Sci. 79:296–303
    [Google Scholar]
  22. 22. 
    Holgate ST, Devlin RB, Wilson SJ, Frew AJ 2003. Health effects of acute exposure to air pollution. Part II: Healthy subjects exposed to concentrated ambient particles. Res. Rep. Health Eff. Inst. 112: 31–50; discussion 51–67
    [Google Scholar]
  23. 23. 
    Sørensen M, Daneshvar B, Hansen M et al. 2003. Personal PM2.5 exposure and markers of oxidative stress in blood. Environ. Health Perspect. 111:161–66
    [Google Scholar]
  24. 24. 
    Kim K, Park EY, Lee KH et al. 2009. Differential oxidative stress response in young children and the elderly following exposure to PM2.5. Environ. Health Prev. Med. 14:60–66
    [Google Scholar]
  25. 25. 
    Riggs DW, Zafar N, Krishnasamy S et al. 2020. Exposure to airborne fine particulate matter is associated with impaired endothelial function and biomarkers of oxidative stress and inflammation. Environ. Res. 180:108890
    [Google Scholar]
  26. 26. 
    Mu G, Zhou M, Wang B et al. 2021. Personal PM2.5 exposure and lung function: potential mediating role of systematic inflammation and oxidative damage in urban adults from the general population. Sci. Total Environ. 755:142522
    [Google Scholar]
  27. 27. 
    Li W, Wilker EH, Dorans KS et al. 2016. Short-term exposure to air pollution and biomarkers of oxidative stress: the Framingham Heart Study. J. Am. Heart Assoc. 5:e002742
    [Google Scholar]
  28. 28. 
    Svecova V, Rossner P Jr., Dostal M et al. 2009. Urinary 8-oxodeoxyguanosine levels in children exposed to air pollutants. Mutat. Res. 662:37–43
    [Google Scholar]
  29. 29. 
    Sorensen M, Autrup H, Hertel O et al. 2003. Personal exposure to PM2.5 and biomarkers of DNA damage. Cancer Epidemiol. Biomark. Prev. 12:191–96
    [Google Scholar]
  30. 30. 
    Krishnan RM, Adar SD, Szpiro AA et al. 2012. Vascular responses to long- and short-term exposure to fine particulate matter: MESA Air (Multi-Ethnic Study of Atherosclerosis and Air Pollution). J. Am. Coll. Cardiol. 60:2158–66
    [Google Scholar]
  31. 31. 
    Riggs DW, Yeager R, Conklin DJ et al. 2021. Residential proximity to greenness mitigates the hemodynamic effects of ambient air pollution. Am. J. Physiol. Heart Circ. Physiol. 320:H1102–11
    [Google Scholar]
  32. 32. 
    Pope CA 3rd, Bhatnagar A, McCracken JP et al. 2016. Exposure to fine particulate air pollution is associated with endothelial injury and systemic inflammation. Circ. Res. 119:1204–14
    [Google Scholar]
  33. 33. 
    O'Toole TE, Hellmann J, Wheat L et al. 2010. Episodic exposure to fine particulate air pollution decreases circulating levels of endothelial progenitor cells. Circ. Res. 107:200–3
    [Google Scholar]
  34. 34. 
    Liang R, Zhang B, Zhao X et al. 2014. Effect of exposure to PM2.5 on blood pressure: a systematic review and meta-analysis. J. Hypertens. 32:2130–40; discussion 41
    [Google Scholar]
  35. 35. 
    Guan T, Xue T, Wang X et al. 2020. Geographic variations in the blood pressure responses to short-term fine particulate matter exposure in China. Sci. Total Environ. 722:137842
    [Google Scholar]
  36. 36. 
    Yang BY, Qian Z, Howard SW et al. 2018. Global association between ambient air pollution and blood pressure: a systematic review and meta-analysis. Environ. Pollut. 235:576–88
    [Google Scholar]
  37. 37. 
    Huang M, Chen J, Yang Y et al. 2021. Effects of ambient air pollution on blood pressure among children and adolescents: a systematic review and meta-analysis. J. Am. Heart Assoc. 10:e017734
    [Google Scholar]
  38. 38. 
    Ntarladima AM, Vaartjes I, Grobbee DE et al. 2019. Relations between air pollution and vascular development in 5-year old children: a cross-sectional study in the Netherlands. Environ. Health 18:50
    [Google Scholar]
  39. 39. 
    Ying Z, Xu X, Bai Y et al. 2014. Long-term exposure to concentrated ambient PM2.5 increases mouse blood pressure through abnormal activation of the sympathetic nervous system: a role for hypothalamic inflammation. Environ. Health Perspect. 122:79–86
    [Google Scholar]
  40. 40. 
    Wang L, Chen G, Pan Y et al. 2021. Association of long-term exposure to ambient air pollutants with blood lipids in Chinese adults: the China Multi-Ethnic Cohort study. Environ. Res. 197:111174
    [Google Scholar]
  41. 41. 
    McGuinn LA, Schneider A, McGarrah RW et al. 2019. Association of long-term PM2.5 exposure with traditional and novel lipid measures related to cardiovascular disease risk. Environ. Int. 122:193–200
    [Google Scholar]
  42. 42. 
    Mao S, Chen G, Liu F et al. 2020. Long-term effects of ambient air pollutants to blood lipids and dyslipidemias in a Chinese rural population. Environ. Pollut. 256:113403
    [Google Scholar]
  43. 43. 
    Ramanathan G, Yin F, Speck M et al. 2016. Effects of urban fine particulate matter and ozone on HDL functionality. Part. Fibre Toxicol. 13:26
    [Google Scholar]
  44. 44. 
    Sun Q, Yue P, Deiuliis JA et al. 2009. Ambient air pollution exaggerates adipose inflammation and insulin resistance in a mouse model of diet-induced obesity. Circulation 119:538–46
    [Google Scholar]
  45. 45. 
    Liu C, Xu X, Bai Y et al. 2017. Particulate air pollution mediated effects on insulin resistance in mice are independent of CCR2. Part. Fibre Toxicol. 14:6
    [Google Scholar]
  46. 46. 
    Wang W, Zhou J, Chen M et al. 2018. Exposure to concentrated ambient PM2.5 alters the composition of gut microbiota in a murine model. Part. Fibre Toxicol. 15:17
    [Google Scholar]
  47. 47. 
    Zheng Z, Xu X, Zhang X et al. 2013. Exposure to ambient particulate matter induces a NASH-like phenotype and impairs hepatic glucose metabolism in an animal model. J. Hepatol. 58:148–54
    [Google Scholar]
  48. 48. 
    Liu C, Fonken LK, Wang A et al. 2014. Central IKKβ inhibition prevents air pollution mediated peripheral inflammation and exaggeration of type II diabetes. Part. Fibre Toxicol. 11:53
    [Google Scholar]
  49. 49. 
    Haberzettl P, McCracken JP, Bhatnagar A, Conklin DJ. 2016. Insulin sensitizers prevent fine particulate matter–induced vascular insulin resistance and changes in endothelial progenitor cell homeostasis. Am. J. Physiol. Heart Circ. Physiol. 310:H1423–38
    [Google Scholar]
  50. 50. 
    Eze IC, Hemkens LG, Bucher HC et al. 2015. Association between ambient air pollution and diabetes mellitus in Europe and North America: systematic review and meta-analysis. Environ. Health Perspect. 123:381–89
    [Google Scholar]
  51. 51. 
    Yang BY, Fan S, Thiering E et al. 2020. Ambient air pollution and diabetes: a systematic review and meta-analysis. Environ. Res. 180:108817
    [Google Scholar]
  52. 52. 
    Zanobetti A, Dominici F, Wang Y, Schwartz JD 2014. A national case-crossover analysis of the short-term effect of PM2.5 on hospitalizations and mortality in subjects with diabetes and neurological disorders. Environ. Health 13:38
    [Google Scholar]
  53. 53. 
    Lim CC, Hayes RB, Ahn J et al. 2018. Association between long-term exposure to ambient air pollution and diabetes mortality in the US. Environ. Res. 165:330–36
    [Google Scholar]
  54. 54. 
    Hart JE, Puett RC, Rexrode KM et al. 2015. Effect modification of long-term air pollution exposures and the risk of incident cardiovascular disease in US women. J. Am. Heart Assoc. 4:e002301
    [Google Scholar]
  55. 55. 
    Pope CA 3rd, Turner MC, Burnett RT et al. 2015. Relationships between fine particulate air pollution, cardiometabolic disorders, and cardiovascular mortality. Circ. Res. 116:108–15
    [Google Scholar]
  56. 56. 
    Schneider A, Alexis NE, Diaz-Sanchez D et al. 2011. Ambient PM2.5 exposure up-regulates the expression of costimulatory receptors on circulating monocytes in diabetic individuals. Environ. Health Perspect. 119:778–83
    [Google Scholar]
  57. 57. 
    Bo Y, Chang LY, Guo C et al. 2021. Associations of reduced ambient PM2.5 level with lower plasma glucose concentration and decreased risk of type 2 diabetes in adults: a longitudinal cohort study. Am. J. Epidemiol. 190:2148–57
    [Google Scholar]
  58. 58. 
    Peng C, Bind MC, Colicino E et al. 2016. Particulate air pollution and fasting blood glucose in nondiabetic individuals: associations and epigenetic mediation in the Normative Aging Study, 2000–2011. Environ. Health Perspect. 124:1715–21
    [Google Scholar]
  59. 59. 
    Lucht SA, Hennig F, Matthiessen C et al. 2018. Air pollution and glucose metabolism: an analysis in non-diabetic participants of the Heinz Nixdorf Recall Study. Environ. Health Perspect. 126:047001
    [Google Scholar]
  60. 60. 
    Cai L, Wang S, Gao P et al. 2019. Effects of ambient particulate matter on fasting blood glucose among primary school children in Guangzhou, China. . Environ. Res 176:108541
    [Google Scholar]
  61. 61. 
    Wang M, Gong L, Zou Z et al. 2020. The relationship between long-term exposure to PM2.5 and fasting plasma glucose levels in Chinese children and adolescents aged 6–17 years: a national cross-sectional study. Sci. Total Environ. 710:136211
    [Google Scholar]
  62. 62. 
    Robertson S, Miller MR. 2018. Ambient air pollution and thrombosis. Part. Fibre Toxicol. 15:1
    [Google Scholar]
  63. 63. 
    Brook RD, Rajagopalan S. 2010. Particulate matter air pollution and atherosclerosis. Curr. Atheroscler. Rep. 12:291–300
    [Google Scholar]
  64. 64. 
    Haberzettl P, Lee J, Duggineni D et al. 2012. Exposure to ambient air fine particulate matter prevents VEGF-induced mobilization of endothelial progenitor cells from the bone marrow. Environ. Health Perspect. 120:848–56
    [Google Scholar]
  65. 65. 
    Kaufman JD, Adar SD, Barr RG et al. 2016. Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study. Lancet 388:696–704
    [Google Scholar]
  66. 66. 
    Atkinson RW, Kang S, Anderson HR et al. 2014. Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis. Thorax 69:660–65
    [Google Scholar]
  67. 67. 
    GBD 2016 Risk Factors Collab 2016. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1659–724
    [Google Scholar]
  68. 68. 
    Burnett R, Chen H, Szyszkowicz M et al. 2018. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter. PNAS 115:9592–97
    [Google Scholar]
  69. 69. 
    Pope CA 3rd, Burnett RT, Krewski D et al. 2009. Cardiovascular mortality and exposure to airborne fine particulate matter and cigarette smoke: shape of the exposure–response relationship. Circulation 120:941–48
    [Google Scholar]
  70. 70. 
    Liang F, Liu F, Huang K et al. 2020. Long-term exposure to fine particulate matter and cardiovascular disease in China. J. Am. Coll. Cardiol. 75:707–17
    [Google Scholar]
  71. 71. 
    Alexeeff SE, Liao NS, Liu X et al. 2021. Long-term PM2.5 exposure and risks of ischemic heart disease and stroke events: review and meta-analysis. J. Am. Heart Assoc. 10:e016890
    [Google Scholar]
  72. 72. 
    Koton S, Molshatzki N, Yuval et al. 2013. Cumulative exposure to particulate matter air pollution and long-term post-myocardial infarction outcomes. Prev. Med. 57:339–44
    [Google Scholar]
  73. 73. 
    Lee PN, Thornton AJ, Forey BA, Hamling JS. 2017. Environmental tobacco smoke exposure and risk of stroke in never smokers: an updated review with meta-analysis. J. Stroke Cerebrovasc. Dis. 26:204–16
    [Google Scholar]
  74. 74. 
    Bilić I, Dzamonja G, Lusić I et al. 2009. Risk factors and outcome differences between ischemic and hemorrhagic stroke. Acta Clin. Croat. 48:399–403
    [Google Scholar]
  75. 75. 
    Shah AS, Langrish JP, Nair H et al. 2013. Global association of air pollution and heart failure: a systematic review and meta-analysis. Lancet 382:1039–48
    [Google Scholar]
  76. 76. 
    Al-Kindi SG, Sarode A, Zullo M et al. 2019. Ambient air pollution and mortality after cardiac transplantation. J. Am. Coll. Cardiol. 74:3026–35
    [Google Scholar]
  77. 77. 
    Pope CA 3rd, Bhatnagar A. 2019. Does air pollution increase risk of mortality after cardiac transplantation?. J. Am. Coll. Cardiol. 74:3036–38
    [Google Scholar]
  78. 78. 
    Yang WY, Zhang ZY, Thijs L et al. 2017. Left ventricular function in relation to chronic residential air pollution in a general population. Eur. J. Prev. Cardiol. 24:1416–28
    [Google Scholar]
  79. 79. 
    Wang F, Ahat X, Liang Q et al. 2021. The relationship between exposure to PM2.5 and atrial fibrillation in older adults: a systematic review and meta-analysis. Sci. Total Environ. 784:147106
    [Google Scholar]
  80. 80. 
    Link MS, Luttmann-Gibson H, Schwartz J et al. 2013. Acute exposure to air pollution triggers atrial fibrillation. J. Am. Coll. Cardiol. 62:816–25
    [Google Scholar]
  81. 81. 
    Dahlquist M, Frykman V, Kemp-Gudmunsdottir K et al. 2020. Short-term associations between ambient air pollution and acute atrial fibrillation episodes. Environ. Int. 141:105765
    [Google Scholar]
  82. 82. 
    Kim IS, Yang PS, Lee J et al. 2019. Long-term exposure of fine particulate matter air pollution and incident atrial fibrillation in the general population: a nationwide cohort study. Int. J. Cardiol. 283:178–83
    [Google Scholar]
  83. 83. 
    Riggs DW, Yeager RA, Bhatnagar A. 2018. Defining the human envirome: an omics approach for assessing the environmental risk of cardiovascular disease. Circ. Res. 122:1259–75
    [Google Scholar]
  84. 84. 
    Yeager RA, Smith TR, Bhatnagar A. 2020. Green environments and cardiovascular health. Trends Cardiovasc. Med. 30:241–46
    [Google Scholar]
  85. 85. 
    Turner MC, Cohen A, Burnett RT et al. 2017. Interactions between cigarette smoking and ambient PM2.5 for cardiovascular mortality. Environ. Res. 154:304–10
    [Google Scholar]
  86. 86. 
    Zhong J, Karlsson O, Wang G et al. 2017. B vitamins attenuate the epigenetic effects of ambient fine particles in a pilot human intervention trial. PNAS 114:3503–8
    [Google Scholar]
  87. 87. 
    Romieu I, Garcia-Esteban R, Sunyer J et al. 2008. The effect of supplementation with omega-3 polyunsaturated fatty acids on markers of oxidative stress in elderly exposed to. PM2.5. Environ. Health Perspect. 116:1237–42
    [Google Scholar]
  88. 88. 
    Bhatnagar A. 2017. Environmental determinants of cardiovascular disease. Circ. Res. 121:162–80
    [Google Scholar]
/content/journals/10.1146/annurev-med-042220-011549
Loading
/content/journals/10.1146/annurev-med-042220-011549
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error