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Illustration: Sarah Grillo/Axios

Doctors should incorporate air pollution to their list of risk factors for heart disease when treating patients, a study out Thursday from the New England Journal of Medicine urges.

The big picture: Air pollution is still overlooked as a cause of heart disease, as outdoor air quality worsens in some parts of the globe.

  • Pairing reduction strategies with cardiovascular disease prevention "could save millions of lives," the authors write.

Why it matters: Heart disease was still the top cause of death for both men and women during the pandemic.

  • Air pollution is the world's fourth leading cause of disease and death, per the World Health Organization.
  • The proportion of deaths from cardiovascular disease in developing countries due to pollution are more than heart disease deaths due to smoking and other behavioral and metabolic risk factors, per the study.

By the numbers: Of the 9 million people who died from pollution worldwide in 2019, 62% died from cardiovascular disease, including heart attacks and stroke, but these estimates are very much undercounted, per the study.

  • Air pollution in the U.S. has drastically improved in the last 50 years compared to other parts of the world, but researchers still estimate 100,000–200,000 people in the U.S. die every year to diseases caused by air pollution.
  • People who live with such dangerous levels of pollution — areas classified as PM 2.5 — have about a 2% increased risk of hospitalization or death from heart failure. Air pollution has also been associated with increased risks of atrial fibrillation and ventricular arrhythmias.

State of play: For decades patients and physicians have incorporated medical history and individual lifestyle behaviors to prevent heart disease. But the same hasn't been done for air pollution despite its deadly exposures.

  • "Just like they take other measures to reduce the risk factors, like stopping smoking, getting more exercise, do what they can to reduce the risk of air pollution," Philip Landrigan, director of the program for global public health and the common good at Boston College and co-author of the study, tells Axios.
  • "I know it's not as easy to change because it's not always within the purview of the individual person to change what kind of air they breathe, but awareness is at least the first step," he added.

What to watch: There are individual roles people could play in reducing exposure to pollution such as masks, air filtration systems and avoiding outdoors in peak times of poor air quality, but the study argues that government-supported interventions in controlling pollution would bring lasting prevention of pollution-related cardiovascular disease.

  • "Only through a multipronged strategy that combines pollution prevention with control of individual risk factors can the global epidemic of cardiovascular disease be contained," the authors write.

Go deeper

Updated Nov 17, 2021 - Health

Retracted: A COVID strategy backfires at schools

Axios has removed the article published here on Nov. 17, 2021, because it fell short of our editorial standards. Axios incorrectly stated that we contacted Global Plasma Solutions for comment before publication. We wrongly relied upon a source who is a former employee of a competitor of GPS and is now an adviser to that same competitor. We apologize to GPS and to our readers.

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True crime documentaries, podcasts and social media campaigns are bringing new attention to real-world legal proceedings — and are often affecting the outcome.

Why it matters: New media platforms can instantly put a national spotlight on cases that have long been forgotten or buried under red tape.

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The world still needs more coronavirus vaccines, but an additional bottleneck has emerged in many low-income countries: They need help getting shots in arms.

Why it matters: Increasing vaccination rates across the world is both a humanitarian necessity and the best way to prevent dangerous new variants from emerging, but it increasingly requires complex problem-solving.