We are increasingly facing the catastrophic consequences of climate change. Unfortunately, climate change due to the impunity of modern societies will have a direct impact on our health. It is noteworthy that the recent estimate of deaths due to exposure to non-optimal temperature (either low or high temperature) reached 1.96 million deaths worldwide1.
A recent study published in the journal Nature Reviews Cardiology highlights the significant changes that will be made to future generations’ cardiovascular health2. With regard to myocardial infarction, the study, based on data collected from 1987 to 2014, concludes that heat exposure is an additional risk factor and mainly affects people with diabetes and hypertension. At the same time, emphasis is placed on the fact that the elderly, patients in low socioeconomic status and patients with underlying diseases remain more prone to these risk factors. Increased heart rate in high temperature conditions can be fatal in people with heart failure or people with underlying diseases (eg chronic kidney disease) whose deterioration can cause acute cardiovascular failure. Unfortunately, heat waves are expected to occur more frequently and will last longer if catastrophic climate change continues3.
Uncontrolled fires, the ever-increasing use of fossil fuels in industry and in automobiles are exponentially exacerbating air pollution. Exposure to airborne pollutants (PM) and particulate matter <2.5 μm in diameter (PM2.5) on both the short and long term has been shown to increase hospitalization and reduce survival in patients with cardiovascular disease. . These particles can be made up of hundreds of harmful chemicals. Generalized inflammation of the body in combination with increased oxidative stress are the main responsible pathophysiological mechanisms. Subsequent endothelial dysfunction and other prothrombotic conditions lead to the early onset of atherosclerotic disease. In addition, there is evidence that air pollution has adverse effects on classical risk factors such as hypertension and diabetes.
Some practical guidelines for reducing exposure to air pollution and high temperature conditions include:
• Monitoring of air quality indicators and weather updates by the media.
• Reduction of non-compulsory travel to areas with high pollution.
• Avoid activities (eg exercise, movement) in periods and areas of high pollution and in conditions of extreme temperatures.
• Use of car filter systems with internal recycling and closed windows.
• Continuous hydration and replenishment of electrolytes.
• Avoid alcohol and caffeine, as they can worsen dehydration due to increased urination.
International policy initiatives for new measures as well as state compliance with the implementation of existing regulations, should be intensified with the aim of protecting the environment and consequently the health of all of us.
References:
1. GBD 2019 Risk Factor Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1223–1249 (2020).
2. Peters, A. and Schneider, A., 2020. Cardiovascular risks of climate change. Nature Reviews Cardiology, 18(1), pp.1-2.
3. De Blois, J., Kjellstrom, T., Agewall, S., Ezekowitz, J., Armstrong, P. and Atar, D., 2015. The Effects of Climate Change on Cardiac Health. Cardiology, 131(4), pp.209-217.
4. Brook, R., Rajagopalan, S., Pope, C., Brook, J., Bhatnagar, A., Diez-Roux, A., Holguin, F., Hong, Y., Luepker, R., Mittleman, M., Peters, A., Siscovick, D., Smith, S., Whitsel, L. and Kaufman, J., 2010. Particulate Matter Air Pollution and Cardiovascular Disease. Circulation, 121(21), pp.2331-2378.
