How air pollution impacts heart health

Watching your cholesterol and blood pressure are vital for heart health. But did you know that air pollution may also affect your heart? Research suggests high levels of particulate air pollution—also known as smog—could raise the risk of heart conditions and other serious health problems.

How might air pollution affect your heart?

Health experts around the world have said that air pollution may harm the heart. The World Heart Federation, American College of Cardiology, American Heart Association, and the European Society of Cardiology published a joint opinion about the issue in 2021, in the Journal of the American College of Cardiology.

They stated that 6.7 million deaths worldwide may have been attributed to air pollution in 2019. Half of these were from cardiovascular diseases. Among all global deaths from cardiovascular disease in 2019, almost 20 percent could be attributed to air pollution.

The joint opinion announcement included plans to advocate for more research linking air quality and heart disease, and to raise awareness with healthcare providers (HCPs) about the risks.

What is particulate air pollution?

Particulate air pollution comes from various sources, like vehicle emissions, smoke, dust, soot, and pollen. In 2023, the American Heart Association (AHA) noted that cardiovascular deaths and disability linked to particulate air pollution had risen by a third globally between 1990 and 2019.

Fine particulate air pollution includes particles smaller than 2.5 microns, usually from sources like car and truck exhaust and wildfires. In 2022, a study published in the Journal of the American Heart Association found that irregular heart rhythms may be triggered by breathing fine particulate air pollution. The link was found in healthy teenagers. It was also found when air pollution levels weren’t very high.

Researchers think that breathing in tiny particles may irritate blood vessels near the heart, and lead to irregular heart rhythms. This issue can be serious, and can sometimes lead to sudden cardiac death in otherwise healthy people.

How might chemicals and extreme temperatures contribute?

In addition to fine particulates, air pollution commonly consists of chemicals like carbon monoxide, sulfur dioxide, ozone, and nitrogen dioxide. A 2022 study published in the journal Circulation suggested that for some people at higher risk for heart problems, such as adults 65 and older, exposure to any level of these common air pollutants may trigger a heart attack.

This was particularly true in cold weather. Another 2023 study, also published in the journal Circulation, found that exposure to extreme temperatures along with air pollution was associated with an even higher risk for death from heart attack, especially for older adults.

Certain types of pollutants may be especially harmful. A 2022 article published in the journal Springer Nature found that the strongest associations between air pollution and cardiovascular diseases were specifically with fine particulates and nitrogen dioxide.

How do you protect yourself?

Even though you may not be able to control the outdoor air quality, there are some ways you can protect yourself.

Here are some tips:

Check the forecast. It can help you to know if you should limit your outdoor activity on high-pollution days, especially if you may be at higher risk for health issues related to pollution. The Centers for Disease Control and Prevention (CDC) says certain groups may be more affected by air pollution. These include:

• People with heart disease, lung disease, and other chronic diseases
• People who are pregnant and their fetuses
• Children
• Older adults
• People who exercise or work outdoors

You can check your daily local air quality report at airnow.gov.

Exercise away from highways and roads. Air pollution is usually worse near vehicle transit systems, so try to exercise in areas that put some distance between you and traffic.

Plan outdoor exercise and activities for the mornings and evenings. These times of day are when pollution levels are often lower.

Don’t exert yourself. If you have to do an outdoor activity at a time or place when air pollution is high, try to do the least strenuous version. For example, walk, rather than run.

Invest in portable air cleaners. The air filters in them will catch particles before you breathe them in. Be sure to get a portable air cleaner that is appropriate for the size and type of room you will be using it in. Try to invest in a high efficiency particulate air (HEPA) filter. These filter out very small particles from the air.

Use a central HVAC unit for your home if possible. Central heating, ventilation, and air conditioning (HVAC) units designed with built-in filters are highly efficient at filtering out particles in the air. Be sure to change the filter regularly.

Keep your heart in good shape. Remember to eat heart-healthy foods, get plenty of rest, and incorporate more exercise into your daily routine, as you are able. Some research has shown that regular exercise, even in areas with high pollution, can still be protective.

Consult your HCP. Many of the heart conditions caused by or triggered by air pollution have medical treatments available—for example, beta blockers are medicines that may help treat irregular heartbeats related to pollution. Talk with your HCP to determine what your risks are for heart conditions related to pollution and what interventions and treatments may be appropriate for you.