State-of-the-Art Paper
Air Pollution and Cardiovascular Injury: Epidemiology, Toxicology, and Mechanisms

https://doi.org/10.1016/j.jacc.2008.05.029Get rights and content
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Recent epidemiologic studies show that increased levels of air pollutants are positively associated with cardiovascular morbidity and mortality. Inhalation of air pollutants affects heart rate, heart rate variability, blood pressure, vascular tone, blood coagulability, and the progression of atherosclerosis. Several categories within the general population (i.e., people with pre-existing cardiovascular disease and diabetic and elderly individuals) are considered to be more susceptible to air pollution–mediated cardiovascular effects. Major mechanisms of inhalation-mediated cardiovascular toxicity include activation of pro-inflammatory pathways and generation of reactive oxygen species. Although most studies focus on the influence of systemic effects, recent studies indicate that ultrafine particles may be translocated into the circulation and directly transported to the vasculature and heart where they can induce cardiac arrhythmias and decrease cardiac contractility and coronary flow.

Key Words

air pollution
cardiovascular effects
mechanisms

Abbreviations and Acronyms

AD
aerodynamic diameter
CAP
concentrated ambient particle
HR
heart rate
HRV
heart rate variability
MI
myocardial infarction
PM
particulate matter
PM10
coarse particle(s) (diameter ≤10 μm)
PM2.5
fine particle(s) (diameter <2.5 μm)
ROS
reactive oxygen species
UAP
urban air particle
UFP
ultrafine particle (diameter <0.1 μm)

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This study was supported by U.S. Environmental Protection Agency (USEPA) STAR Grant No. RD-83195201 and the Gwladys and John Zurlo Charitable Foundation.