Climate change and cardiovascular health: Welcome back to “The Science Of Health”, ABP Live’s weekly health column. Last time, we explained how reheating food and cooking food at high temperatures change its chemical constituents, and how these are linked to increased heart disease risk. This week, we explain how climate change and air pollution affect cardiovascular health, which communities are most vulnerable to the impacts of climate change, and what must be done to reduce the risk of heart diseases occurring as a result of climate change.
Climate change severely impacts one’s health due to changing temperature and weather patterns, and increasing levels of greenhouse gases.
How climate change and air pollution impact cardiovascular health
Fossil fuel combustion results in air pollution, extreme heat, and severe weather patterns, all of which are directly as well as indirectly linked to increases in cardiovascular morbidity and mortality.
The geographical location in which one resides also determines the impact of climate change on their heart health. For instance, people living in flood-prone areas are susceptible to vector-borne diseases, while those living in drought-prone regions are likely to suffer from starvation, malnutrition, and dehydration. Also, low- and middle-income countries are the most vulnerable to the negative impacts of climate change due to socio-economic constraints. They do not have the resources to overcome the impacts of climate change.
It is important for healthcare professionals to understand the effects of climate change so that they can collaborate with scientists to develop strategies to reduce the burden of climate change on the health of humans and all living beings.
There is a direct link between climate-sensitive stressors and cardiovascular health. This is because climate-sensitive stressors such as air pollution, extreme heat, and severe weather patterns can affect food, water supply and quality, and power, all of which can impact migratory patterns of both humans and vector-borne diseases, according to a December 2022 article published in the Journal of the American Heart Association.
Floods result in power outages, both of which are linked with an increased risk of cardiovascular disease.
Climate change leads to high temperatures, which result in increasing levels of ground-level ozone. This increases the risk of wildfire and dust storms, resulting in a higher demand for electricity. This in turn increases demand for fossil fuel consumption and air pollution. Again, air pollution leads to ground-level ozone, and the vicious cycle continues.
Increased levels of fine particulate matter such as PM2.5 and PM10 have detrimental effects on cardiopulmonary health.
According to the 2020 Global Burden of Disease Study, more than 80 people per 100,000 population in India and China die due to air pollution, the article said.
“Climate change is not just making Earth hotter, but our hearts are also feeling the heat. New Delhi and Beijing, which are the global epicentres of pollution, are seeing a rise in cardiovascular problems. Recent findings link 11% of heart-related deaths worldwide to poor air quality and environmental degradation. When we inhale polluted air, our lungs grapple with harmful particles. The heart, in turn, faces added strain, especially in those with pre-existing conditions like hypertension,” Dr Niranjan Hiremath, Senior Consultant cardiovascular and aortic surgeon, and surgical lead, Apollo Hospital, told ABP Live.
Extreme heat is associated with increased cardiovascular disease-related emergency department visits, and heat stress causes increased cardiac workload to compensate for the body’s vasodilatory response to heat, inflammation, and hemoconcentration (an increase in the concentration of blood cells due to loss of plasma or water from the body).
Due to global warming and climate change, certain regions on the planet are likely to experience the adverse impact of climate change more compared to other areas. There will be extreme weather events such as intense rainfall, storm surges, and coastal flooding in these regions. Post-hurricane mortality data has shown that destructive windstorms impact cardiovascular mortality and heart disease is a major cause of death, representing 11 per cent of deaths. For instance, Hurricane Sandy in 2012 resulted in increased myocardial infarction (blockage of blood flow to the heart muscle) incidence.
“Soaring temperatures intensify dehydration and heart issues. With heart ailments and environmental perils intertwining more than ever, it is clear – as the planet’s health goes, so does ours,” said Dr Hiremath.
Climate change impacts agricultural production, food security, and political stability, especially among vulnerable communities, the article said.
During the years of the El Niño-Southern Oscillation, the probability of new civil conflict arising in the tropics increased by two times, the article said, citing a study.
Climate change also leads to the contamination of soil and water due to pollution, and the use of harmful chemicals, all of which together degrade the quality of crops. Consumption of such food increases the risk of hypertension, diabetes, cancer, and heart disease.
These climate change impacts indirectly make it difficult for people to adopt a heart-healthy diet, and some people do not have access to cardiovascular health care.
How are vulnerable communities more prone to the impacts of climate change and cardiovascular disease?
Communities which are more vulnerable and sensitive to the impacts of climate change, have less adaptive capacity to cope with the challenges, and are likely to suffer from worse health outcomes, compared to other sections of society, include the people who live in areas where the probability of floods, droughts and storms occurring is high.
Between 2000 and 2010, mortality from floods, droughts and storms was 15 times higher in highly vulnerable regions than in regions with low vulnerability.
Older adults, people with pre-existing cardiovascular disease, and those living with socioeconomic constraints are vulnerable to cardiovascular morbidity due to climate change impacts.
“Climate change poses significant risk to cardiovascular health, extreme weather variation like extreme heat or extreme cold can increase the workload of the heart and eventually lead to increase in incidence of heart attacks. It has been seen that climate induced stress can affect patients who already have a heart problem or who are prone for heart problems,” Dr Arun Kumar Gupta, Associate Director, Cardiology, Max Hospital Gurugram, told ABP Live.
People who live in poverty are more likely to be exposed to extreme heat and air pollution, and hence, they are more vulnerable to cardiovascular disease.
For every 10 micrograms per cubic metre increase in annual fine particulate matter, there is an increased mortality hazard ratio of 1.26 for the people who have undergone cardiac transplantation, a study found, the article said.
According to the American Heart Association, air pollution is the strongest environmental risk factor of cardiovascular disease.
When particulate matter enters the bloodstream through lung capillaries, the pollutants damage the arteries of the heart, resulting in increased risk of heart attacks.
“Air pollution because of smoke, fog, or a high percentage of particulate matter 2.5 can increase the incidence of heart attack. The small particles can enter the circulation through the capillaries of the lung and they can directly damage the arteries of the heart, leading to increased incidence of heart attack,” said Dr Gupta.
Not only are vulnerable communities more susceptible to cardiovascular diseases due to heat waves, wildfires, and air pollution, but also due to reduced access to green space, which itself has been linked with higher rates of cardiovascular disease.
A heat wave may result in power outages, which people with pre-existing cardiovascular conditions may not be able to cope with. Droughts and floods may delay the delivery of medicines, and people may have to cancel their plans to visit healthcare professionals.
Since there is an increased risk of heart disease due to climate change risks, especially among vulnerable communities, it is important to educate them about the risk from exposure, and support them so that the risk of disease is reduced.
“So, patients who have a heart problem or who are prone to heart problems should avoid extreme weather or extreme heat or cold. Whenever they are going out for morning walks they can wear masks and even at home they can use air purifiers to minimise the effect of air pollution on the heart,” said Dr Gupta.
What must be done to reduce the risk of cardiovascular disease due to climate change?
It is difficult to predict the extent to which the world’s climate and weather patterns will continue to change, and what their impact on human health will be. However, more research needs to be conducted to increase the understanding of mechanisms through which climate change affects heart health, and what adaptation and mitigation strategies must be adopted to reduce these risks.
According to the article, some of the strategies being used at present to reduce cardiovascular disease risk include adaptation strategies at the individual level, such as ensuring that patients have access to air conditioning on extreme heat days, and mitigation strategies at the societal level, such as advocating for regulations that stop pollution.
Since environmental exposures and the changing environment are closely linked to cardiovascular health, clinical cardiologists, climate scientists, and environmental epidemiologists must collaborate to better understand the health effects of climate change, and to help patients develop strategies to reduce the risk of heart disease.
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