Can air pollution lead to heart attack?

Yes, prolonged exposure to air pollution may lead to heart attacks. Irrespective of where we reside, small particle pollutants can be problematic for the heart over a long period.

Air pollution has been an often neglected cause of heart-related ailments. But it's now becoming a matter of interest owing to the deteriorating quality of human health. The World Health Organization estimated that 7 million people worldwide die yearly from exposure to air pollution out of which 3.3 million deaths are attributed to cardiovascular disease. This figure is higher than most modifiable cardiovascular disease risks like smoking, hypertension, hyperlipidemia, and diabetes mellitus.

Air pollution can be anywhere, be it the traffic-prone areas, industrial premises, metropolitan cities, or even at home. Ambient or outdoor air pollution from vehicular and industrial emissions, comprises pollutants like carbon dioxide (CO2), oxides of sulfur and nitrogen, particulate matter, and numerous other compounds in either particulate or gaseous form. 

Particulate pollutants are identified as one of the most harmful components having detrimental effects on the heart.  They are extremely small in comparison to visible matter such as fine sand, human hair, etc. Particulate matter comprises dust particles that are graded by measuring their diameter in microns. Most microparticles are between approximately 1 and 1000 micrometers in size while nanoparticles are less than 100 nanometers. The important types of particulate matter are PM2.5 and PM10 from a public health perspective. PM2.5 vs PM10, both are microscopic, as illustrated below:

Several studies have proven that particle pollutants, also known as Particulate Matter are invisible and can cause hazards to our hearts. On breathing, these particles are introduced to the bloodstream traveling through the lungs to the heart leading to chronic diseases. Both short-term and long-term exposure to particle pollution is linked to an increased risk of heart ailments. 

In a 2016 medical journal, Dr. Joel Kaufman, a professor at, the University of Washington examined the severity of short-term and long-term exposure to air pollution and found that long-term exposure to particulate matter and nitrogen oxides at levels close to the National Ambient Air Quality Standards (NAAQS) could prematurely age blood vessels and contribute to a rapid buildup of calcium in the coronary artery. This can restrict blood flow to the heart and other major blood vessels; increasing the chances of cardiovascular events like heart attack and stroke.

Another research conducted by the American Heart Association examined the toxicity of the particulate pollutants entering the heart and found that the phenomenon called Particle radioactivity enhances PM2.5 toxicity and increases the risk of death from cardiovascular disease, especially from a heart attack or stroke. Particle radioactivity is a characteristic of air pollution that reflects the colorless, odorless gas radon found in fine particulate matter (PM2.5) air pollution.  

How can polluted air lead to heart-related diseases?

• Damage your blood vessels by making them narrower and harder leading to clotting and increased blood pressure.
• Affect your heart’s electrical system that controls your heartbeat, in the form of an unstable heart rhythm.
• Potentially cause small changes to the structure of your heart, as in the early stages of heart failure.

Cardiologist Dr. Srikanth Sola, senior honorary consultant at Sri Sathya Sai Institue of Medical Sciences shared his first-hand experience with young patients suffering from heart diseases caused by air pollution, 

“I saw patients as young as in their twenties with heart and lung problems losing their lives due to air pollution. My first experience with heart disease due to air pollution occurred in a twenty-eight-year-old shoe cobbler who suffered a heart attack but fortunately survived with the help of emergency surgery. The same is not the case with every patient.”

To reduce the exposure or manage the severity of air pollution on our health, he further suggests, 

“the actions individuals can take to reduce the risk of heart disease due to air pollution include using air purifiers if residing in areas with high air pollution. An additional diet rich in antioxidants found in fresh fruits and vegetables has been shown to blunt to some extent the negative effects of air pollution. Avoid traveling to polluted areas whenever possible and wear an N95 face mask to limit the inhalation of toxic particles.”

How to reduce exposure to air pollution?

There are many ways to reduce our exposure to air pollution: 

• If residing in an area prone to poor air quality, reduce the time spent outside during rush or operational hours. 
• Choose routes away from busy roads, such as cycling paths, while walking or cycling.
• Plan your commute well in advance and accordance with the traffic hours. 
• Avoid exercising outdoors. 
• Research has suggested eating a balanced diet with plenty of fruits and vegetables could protect you from the negative impacts of air pollution.
• World Health Organization (WHO) states that masks are a key measure to reduce transmission. 

Air pollution can lead to heart ailments and may lead to harmful effects on heart patients. We need a collective vision with actionable steps to overcome air pollution. As winter is approaching and just a seasonal agenda during winter will be a short-lived goal. With awareness drives, individual initiatives along with a realistic action plan to monitor and thus control air pollution, we can inch onward toward the target of a healthy life and a greener planet.