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Climate change and cardiovascular health: red warning

Climate change – which encompasses the long‐term changes in temperature and weather patterns seen since the Industrial Revolution, attributed in large part to increasing levels of greenhouse gases – is increasingly recognised for its far‐reaching consequences on human health.

The consequences of fossil fuel combustion that range from air pollution to extreme heat and to severe weather patterns can translate both directly and indirectly to increases in cardiovascular morbidity and mortality.

These climate‐sensitive stressors can affect food, power, water supply and quality, which can also impact migratory patterns of both human and vector‐borne diseases.

High temperatures lead to increasing levels of ground‐level ozone, a greater risk of wildfire and dust storms, and a higher demand for electricity – which, in turn, increases demand for fossil fuel combustion and air pollution.

Air pollution – such as elevated levels of fine particulate matter – has detrimental effects on cardiopulmonary health.

Separately, extreme heat is linked to increased cardiovascular disease–related emergency department visits.

Heat stress can manifest physiologically via increased cardiac workload (to compensate for the body’s vasodilatory response to heat), hemoconcentration, and inflammation, and, in severe circumstances, it can lead to autonomic dysfunction.

Furthermore, current climate models predict that certain regions of the globe will experience more intense rainfall, coastal flooding, and storm surges in the face of global warming. Destructive windstorms significantly impact cardiovascular mortality, as heart disease has been shown to be a major cause of death (representing 11% of deaths) in post-hurricane mortality data, following drowning and trauma or injury‐related deaths.

Although the impact of these events on cardiovascular disease is difficult to quantify, they are unlikely to encourage the adoption or maintenance of a heart‐healthy diet, regular cardiovascular exercise, and access to care, all of which are fundamental in maintaining cardiovascular health.

Large research gaps in quantifying the impacts of climate change on cardiovascular health remain, and given the complex and multidisciplinary nature of the topic, stand to benefit from interdisciplinary collaborations among clinical cardiologists, climate scientists, and environmental epidemiologists, among other research professionals, to better elucidate the overall burden of disease and what mitigation and/or adaptation strategies are most cost effective.

The extent to which our world’s climate and weather patterns will continue to change and their ultimate impact on human health is difficult to predict, but it is clear that climate change has already adversely affected health globally.

Current strategies to reduce known risks of cardiovascular disease include adaptation strategies at the individual level (e.g., ensuring that patients have access to air conditioning on extreme heat days) and mitigation strategies at the societal level (e.g., advocating for regulations that stop pollution at its source).

Environmental exposures and our changing environment are intricately related to cardiovascular health. Accordingly, it is vital that the clinicians better understand the health effects of climate change to empower their patients to develop strategies to reduce their risk of cardiovascular disease.

Article submitted by HPA Group