Heart disease patients have a unique vulnerability to air pollution

Air pollution is a silent menace that can subtly worsen the heart conditions that many patients battle daily. Often, we are not aware of the full extent of this danger.

Unlike viruses or bacterial infections, which are more tangible and typically easier to detect and manage, this invisible threat arises from the very air we breathe, infiltrating our bodies with harmful particles that can exacerbate chronic heart issues.

A new study by heart researchers at Intermountain Health in Salt Lake City finds that patients with heart disease, particularly those who have suffered heart failure, are especially vulnerable to the impacts of air pollution and poor air quality.

Air pollution and heart health

The results of the study were presented at the American Heart Association’s 2024 Scientific Sessions international conference in Chicago.

The experts found that two inflammatory markers – CL27 (C-C motif chemokine ligand 27) and IL-18 (interleukin 18) – were elevated in heart failure patients who were exposed to poor air quality, but did not change in those without heart disease.

This suggests that air pollution places additional stress on the bodies of patients with pre-existing heart conditions.

“These biomarkers rose in response to air pollution in people who already had heart disease, but not in patients who were heart disease free, showing that heart failure patients are not as able to adapt to changes in the environment,” said Dr. Benjamin Horne, the study’s principal investigator, is a professor of research at Intermountain Health.

The findings emphasize the unique vulnerability of individuals with heart problems, and highlight the need for targeted protective measures to mitigate the harmful effects of poor air quality.

Unraveling the research process

The retrospective study involved collaboration between Intermountain Health researchers and scientists from Stanford University and the Harvard School of Public Health.

They analyzed blood samples from patients enrolled in the Intermountain INSPIRE registry, which collects blood, biological samples, medical information, and laboratory data from both healthy individuals and those with various medical conditions.

Identifying air pollution peaks

The researchers examined blood for 115 different proteins that are indicative of increased inflammation.

The samples came from 44 heart failure patients and 35 individuals without heart disease.

Blood was drawn on days with low air pollution (PM2.5 levels under 7 μg/m3) and days on which pollution spiked (PM2.5 levels of 20 μg/m3 or higher). This allowed the researchers to compare the samples and determine the effects of pollution spikes.

The spikes were due either to summer wildfire smoke or winter inversions, where warm air traps pollution close to the ground.

Proactive measures for heart patients

“It’s important that individuals with known heart disease, including those diagnosed with heart failure, need to be especially cautious during periods of poor air quality,” said Dr. Horne.

“This includes exercising indoors, making sure to take their prescribed medications, and avoiding areas like roadways and highways where there’s a lot more traffic and pollution.”

Why air quality matters

The results of this study highlight a pressing need for enhanced public education and prevention among heart patients during times of adverse air quality.

Air pollution is an increasingly common problem, in both developed and developing countries. This is due, in part, to urbanization, industrial emissions and climate change.

Individuals with heart diseases, along with many others, have increased susceptibility. The study reiterates the need for improved air quality monitoring and public health interventions that are centered on heart patients’ needs.

In terms of healthcare professionals, these findings pave the way for more focused education for patients with a comorbid condition.

Physicians may advise that the suggested strategies be implemented, such as having air purifiers at home or not opening windows during days of poor air quality.

This proactive approach not only mitigates immediate health risks but also promotes long-term well-being for heart patients.

In addition, policymakers may use research like this as the foundation for their advocacy of stronger air quality standards and environmentally conscious, sustainable urban planning that decreases pollution-emitting sources.

If stricter regulations on emissions are enacted, coupled with a focus on cleaner technologies, communities can protect more than just heart patients. The public in general will benefit by improving overall health, reducing healthcare burdens for governments.

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