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HERO ID
7503391
Reference Type
Journal Article
Subtype
Review
Title
Developing a Clinical Approach to Air Pollution and Cardiovascular Health
Author(s)
Hadley, MB; Baumgartner, J; Vedanthan, R
Year
2018
Is Peer Reviewed?
Yes
Journal
Circulation
ISSN:
0009-7322
EISSN:
1524-4539
Volume
137
Issue
7
Page Numbers
725-742
Language
English
PMID
29440198
DOI
10.1161/CIRCULATIONAHA.117.030377
Web of Science Id
WOS:000424954800012
Abstract
Nearly 3 billion people are exposed to household air pollution emitted from inefficient cooking and heating stoves, and almost the entire global population is exposed to detectable levels of outdoor air pollution from traffic, industry, and other sources. Over 3 million people die annually of ischemic heart disease or stroke attributed to air pollution, more than from traditional cardiac risk factors such as obesity, diabetes mellitus, or smoking. Clinicians have a role to play in reducing the burden of pollution-attributable cardiovascular disease. However, there currently exists no clear clinical approach to this problem. Here, we provide a blueprint for an evidence-based clinical approach to assessing and mitigating cardiovascular risk from exposure to air pollution. We begin with a discussion of the global burden of pollution-attributable cardiovascular disease, including a review of the mechanisms by which particulate matter air pollution leads to cardiovascular outcomes. Next, we offer a simple patient-screening tool using known risk factors for pollution exposure. We then discuss approaches to quantifying air pollution exposures and cardiovascular risk, including the development of risk maps for clinical catchment areas. We review a collection of interventions for household and outdoor air pollution, which clinicians can tailor to patients and populations at risk. Finally, we identify future research needed to quantify pollution exposures and validate clinical interventions. Overall, we demonstrate that clinicians can be empowered to mitigate the global burden of cardiovascular disease attributable to air pollution.
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