Air Pollution May Raise Risk Of Carotid Artery Stenosis

Jonathan D. Newman, MD, MPH Instructor of Medicine The Leon H Charney Division of Cardiology and The Center for the Prevention of Cardiovascular Disease New York University School of Medicine NY, NY 10016MedicalResearch.com Interview with:
Jonathan D. Newman, MD, MPH
Instructor of Medicine
The Leon H Charney Division of Cardiology and
The Center for the Prevention of Cardiovascular Disease
New York University School of Medicine
NY, NY 10016

Medical Research: What is the background for this study? What are the main findings?

Dr. Newman: Outdoor fine air pollution (PM2.5 defined as mass concentration of particles < 2.5µM) is ubiquitous and associated with cardiovascular mortality, ischemic heart disease events and stroke.   There are known vascular and hemodynamic effects of air pollution exposure that may explain some, but not all, of this increased risk.  However, prior to this study it was unknown whether fine particle air pollution exposure is associated with prevalent clinical atherosclerosis, such as carotid artery stenosis.

For the first time we examined the association between fine particle air pollution exposure and carotid artery stenosis in over 300,000 people living in New York, New Jersey and Connecticut.  Working with colleagues in Environmental Medicine from NYU Langone Medical Center, we used data from the Environmental Protection Agency’s Air Quality System to estimate the average annual fine particle air pollution by zip code in the tri-state area.  Air pollution data was then associated with the results of vascular screening tests from tristate residents age 40-80 participating in the Life Line Vascular Screening  (LLS, Independence, Ohio).

After adjusting for the effects of known cardiovascular disease risk factors such as smoking, hypertension, hyperlipidemia, diabetes and physical inactivity, we found that each 10µg/m3 increase in air pollution exposure was associated with a nearly two-fold increase in risk of carotid artery stenosis (OR 1.90, 95% CI (1.35-2.66).  Similarly, compared to the lower levels of air pollution exposure, participants in the highest fourth of air pollution exposure had a 24% increased risk in carotid artery stenosis (OR 1.24 95% CI 1.11-1.37).

Medical Research: What should clinicians and patients take away from your report?

Dr. Newman: Our study shows that air pollution exposure has important vascular effects, even at lower levels of exposure.  It also shows that these effects are independent of known strong risk factors for cardiovascular disease, such as smoking, high blood pressure and high cholesterol.  Our findings support public health and governmental initiatives to limit and/or reduce air pollution exposure, and also indicate that it may be prudent for individuals with high risk of cardiovascular disease such as people with prior known heart disease, strokes, diabetes or vascular disease to limit the time spent outdoors when indices of air quality are poor.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Newman: Future studies need to investigate the specific components of air pollution that are associated with vascular disease risk, and to better characterize populations of individuals that – such as people with diabetes – that may have a higher risk of cardiovascular disease with air pollution exposure.  Finally, our study also supports future research into novel strategies to reduce or ameliorate the vascular risks of environmental exposures.

Citation:

Presented at ACC15 and

Particulate Air Pollution and Carotid Artery Stenosis
Jonathan D. Newman, MD, MPH; George D. Thurston, ScD; Kevin Cromar, PhD; Yu Guo, MA; Caron B. Rockman, MD; Edward A. Fisher, MD, PhD; Jeffrey S. Berger, MD, MS

J Am Coll Cardiol. 2015;65(11):1150-1151. doi:10.1016/j.jacc.2014.12.052

 

MedicalResearch.com Interview with: Jonathan D. Newman, MD, MPH (2015). Air Pollution May Raise Risk Of Carotid Artery Stenosis 

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