Environmental risk factors and cardiovascular diseases



by LORENZO CIOTTI

Environmental risk factors and cardiovascular diseases

Cardiovascular risk factors are specific conditions that are statistically related to a cardiovascular disease, and which are therefore thought to contribute to its pathogenesis. The risk factors are therefore not to be considered causal agents, but indicators of the probability of the appearance of coronary artery disease; their absence does not exclude the appearance of the disease, but the presence of one of them, and even more so the co-presence of multiple risk factors linked to each other, considerably increases the risk of onset and development.

The risk factors interact with each other, intervening on the pathogenesis of coronary artery disease in a factorial and not simply additive manner, which means that the risk of death from myocardial infarction increases considerably in the presence of two, three or more risk factors even when these are present to a clinically insignificant extent.

The common effort of all Scientific Societies to identify the best tests with the greatest guarantee of success has unfortunately not led to consistent data, as can be seen from the sometimes conflicting results. In fact, the current international guidelines do not recommend the indiscriminate use of most of these screening tests on the entire population, but the use commensurate with the possibility of pathology, resulting from the anamnesis and familiarity of the individual being examined.

The most used are obviously also the most easily evaluated by outpatient medicine: intima-media thickness with arterial Doppler, microalbuminuria and glycosylated hemoglobin, and mitro-aortic calcifications with an echocardiogram.

Environmental risk factors and cardiovascular diseases: a comprehensive expert review, study published on the Cardiovascular research, explained: "Non-communicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality.

The majority of these deaths are caused by cardiovascular disease (CVD) The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night, and climate change, including heat extremes, desert storms, and wildfires.

In addition to the traditional risk factors for CVD such as diabetes, arterial hypertension, smoking, hypercholesterolaemia, and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers.

Furthermore, urbanization is associated with accumulation and intensification of these stressors This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs.

We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on CVD."