What things are in the air that harm our health and how do they affect us?

Air pollution is one of the main responsible for the global burden of disease of various kinds. Thus, according to the World Health Organization (WHO), it is estimated that 31% of cardiovascular diseases could be avoided if we could eliminate environmental pollutants.

“Cardiovascular disease is extraordinarily prevalent in developed societies like ours, causing more than 330 deaths a day in our country”, highlights the doctor Angel Cequier, president of the Spanish Society of Cardiology (SEC).

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“After the dramatic situation suffered by the pandemic, we must put into context that the high mortality from cardiovascular diseases continues to occur and we must continue to fight to try to raise awareness in all prevention measures,” adds the expert.

Pollution kills

The relationship between pollution and some diseases, such as respiratory diseases, is well known, but its damages go much further. Half of the 6.7 million deaths attributable to air pollution in 2019 were due to cardiovascular reasons, as shown in the study Taking a Stand Against Air Pollution – The Impact on Cardiovascular Disease.

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Its weight in cardiovascular disease is such that it is already considered the fourth risk factor causing more mortality, only behind hypertension, smoking and poor diet.

«Currently, the treatment and prevention of cardiovascular disease is basically focused on the control of classic risk factors: hypertension, high cholesterol, diabetes, sedentary lifestyle, being overweight or obese, and smoking«, Explains Dr. Ana Navas-Acién, epidemiologist and professor at the Mailman School of Public Health at Columbia University.

But, “strategies to address environmental contamination as a fundamental element for prevention have not yet been incorporated into routine clinical practice in cardiology,” adds Navas-Acién.

“Clinical practice guidelines should be updated and include environmental exposures as risk factors to develop public health strategies,” he says.

Pollution, at low levels, causes cardiovascular diseases

Air pollutant particles enter our body through the respiratory tract. They pass very easily into the blood, passing through the alveoli and from there to the rest of the organs and tissues. They can also pass directly to the nervous system via the olfactory nerve.

Among the chemical compounds with the highest risk for public health According to the WHO, there are, in addition to air pollution, asbestos, arsenic, benzene, cadmium, dioxin, fluoride, mercury, pesticides and lead.

Epidemiological studies of large American cohorts such as the Strong Heart Study, MESA or NHANES show how lead, cadmium and arsenic, together with air pollution with fine particles, even below the legally established limits, are especially harmful to the development of cardiovascular disease of atherosclerotic origin.

Drugs that help remove heavy metals

“But we must take one more step for action,” says Navas-Acién. “There are already clinical trials, such as the TACT (Trial to Assess Chelation Therapy), funded by the NIH (Institutes of Health of the United States), which demonstrate the effectiveness of drugs that remove heavy metals such as lead and cadmium, through urine, for the treatment of cardiovascular disease of arteriosclerotic origin ”, he explains.

For the analysis, 1,708 cardiovascular patients from the US and Canada were followed for 55 months. 55,222 infusions were administered, including placebos and chelating drugs (EDTA). Deaths, heart attacks and coronary revascularization were reduced. The benefits were even greater in diabetic patients.

“In light of the scientific evidence, we should consider incorporating a new subdiscipline, ‘Environmental Cardiology’, into routine clinical practice. This is essential to face environmental challenges and climate change in the 21st century. The objective is clear: to protect and treat patients and the population from the harmful effects of environmental pollution and, especially, the most vulnerable populations ”concludes Dr. Navas-Acién.