According to a study presented at the European Society of Cardiology (ESC) scientific symposium Heart Failure 2023, heart failure patients are at a higher risk of dying from their disease on polluted days and for up to two days after exposure.
The findings indicate that reducing air pollution has the potential to prevent worsening heart failure. Protecting vulnerable groups, especially during winter, should become an integral part of clinical care. That means health professionals working with patients to monitor air quality and choose optimal times for outdoor activity.
Dr. Lukasz Kuzma, Study Author, Medical University of Bialystok
Air pollution is the single most important environmental threat to human health, according to the World Health Organisation (WHO). This comprises PM2.5 and PM10 particles, which are mostly caused by vehicle exhaust pollution and industrial pollutants. Ambient air pollution was estimated to cause 4.2 million premature deaths worldwide in 2019.
Heart failure affects over 64 million people globally. The authors of the current study previously discovered that increases in particulate matter were associated with an increase in heart failure hospitalisations. The purpose of this study was to investigate the relationship between smog exposure and short-term heart failure mortality.
From 2016 to 2020, the Central Statistical Office released mortality data from five main cities in Eastern Poland. PM2.5 and PM10 readings were provided by the Inspectorate for Environmental Protection. Using residential postcodes, individual pollution exposure was connected to death.
The researchers used a time-stretched case-crossover approach, with volunteers serving as controls. This eliminated the risk of individual differences influencing the results.
Pollutant levels on the day of the week when a death occurred (e.g., Tuesday) were compared to pollutant levels on the same day of the week when no deaths occurred (e.g., all subsequent Tuesdays) in the same month for each participant.
To examine pollution levels, the analyses were performed one and two days before a death. All studies were controlled for variables such as time of year, weekday, weather conditions (temperature, humidity, and air pressure), and long-term trends such as population demographics.
87,990 deaths were recorded over the five-year research, with heart failure accounting for 7,404 of them. Individuals who died from heart failure had an average age of 74 years old, with women accounting for 49% of those who died.
Winter had the most deaths, while summer had the fewest, with daily averages of 1.03 and 0.69, respectively. On a polluted day, a 10 g/m3 rise in PM2.5 and PM10 was associated with a 10% and 9% increase in the chance of death due to heart failure, respectively. Similar chances of dying from heart failure were found one and two days after pollution exposure.
The results suggest that pollution continues to exert negative effects on heart health for two days after smog exposure. Patients with heart failure should minimize their time in polluted areas, for example by avoiding outdoor activities in places with dense traffic or when pollution levels are high, and using air filters at home. In addition, patients can advocate for policies and actions to improve air quality in their communities.
Dr. Lukasz Kuzma, Study Author, Medical University of Bialystok
“Our research indicates that considering the impact of pollution in public health measures to prevent disease and the consequences of ill health could lead to positive outcomes for patients with heart failure. Such measures should be taken in parallel with clinical care to improve the prognosis of this condition,” Dr. Kuzma concluded.
The project is supported by the National Science Centre in Poland grant UMO-2021/41/B/NZ7/03716 and by research grants from the Medical University of Bialystok UMB- B.SUB.23.290 and UMB-B.SUB.23.509.
Source: https://www.escardio.org/
