Poland is currently experiencing unprecedented heatwaves alongside existing cold waves, raising concerns about the adverse impact of climate change and pollution on cardiovascular risk.
“Climate change is driving extreme weather events, yet temperate climates remain understudied,” said Lukasz Kuzma, professor at the Medical University of Bialystok in Poland.
His team recently performed a geospatial analysis of more than 8 million residents of Eastern Poland. The primary endpoint of major adverse cardiovascular and cerebrovascular events (MACCE) included cardiovascular death, ST-segment elevation myocardial infarction and ischaemic stroke.
Over the time period, 573,538 MACCE events, 377,373 cardiovascular deaths and 831,246 all-cause deaths were recorded. Both heatwaves and cold waves were associated with significant increases in events, but with distinct temporal patterns.
For example, heatwaves had an immediate impact. On the day of exposure to heatwaves, MACCE increased by 7.5% and cardiovascular deaths increased by 9.5%. Meanwhile, cold waves produced a delayed and more sustained effect, with the risk of MACCE rising from 4.0% to 5.9% over several days after exposure and the risk of cardiovascular death rising from 4.7% to 6.9%.
Exposure to air pollution further amplified the effects of extreme temperatures, with O3 and benzo(a)pyrene intensifying the effects of heatwaves, while O3, particulate matter (PM2.5) and NO2 exacerbated the impact of coldwaves.
“Our results highlight that the problems of climate change now extend to Northern Europe and demonstrate the considerable combined hazards of temperature extremes and air pollution on increasing cardiovascular events,” said Kuzma.
A separate analysis by colleague Anna Kurasz evaluated the short- and long-term effects of air pollution on major cardiovascular events. A total of 377,344 deaths due to cardiovascular disease were recorded. About 13% of cardiovascular deaths were associated with air pollution, corresponding to 71,440 years of life lost over the decade. PM2.5 and benzo(a)pyrene were found to be important contributors to MACE risk, with the greatest vulnerability observed in women and younger people. Monthly air pollution exposure increases were associated with up to a 10% rise in MACE and these effects were ~5% higher in women than men and ~9% higher in individuals aged younger than 65 years compared with older than 65 years.
“These results challenge the traditional risk factor paradigm about which groups of individuals are most susceptible,” said Kurasz. “Our findings clearly support the need for coordinated public health policies aimed at reducing air pollution and also for further investigations into who is most affected and the mechanisms responsible.”
Kuzma said his team will continue to study the wider exposome, including light and noise pollution. They are also working on developing a method to incorporate environmental factors into a cardiovascular risk prediction algorithm to enable more effective targeting of preventive efforts.
Data from European Society of Cardiology