Air pollution, extreme temperatures and environmental hazards are increasingly threatening heart health worldwide, experts say. Research shows that people living in polluted air face a 15% to 20% higher risk of heart attack, even if they do not smoke.
On the occasion of World Heart Day, celebrated annually on Sept. 29 by the World Heart Federation, cardiologists are calling attention to the growing impact of environmental factors on cardiovascular disease, which, together with stroke, causes approximately 17 million deaths globally each year.
Professor Ertuğrul Okuyan, vice president of the Turkish Society of Cardiology, explained that environmental hazards, including microplastics, noise and light pollution, and extreme weather events linked to climate change, pose far greater risks to heart health than commonly perceived.
“Air pollution is by far the most harmful environmental problem for heart health because we are all exposed to it every day with every breath,” Okuyan said. “Research clearly shows that people living in polluted air have a 15% to 20% higher risk of heart attack. Even if you don’t smoke, living in polluted air puts you at risk. Combating air pollution must be a top priority.”
Even short-term exposure to polluted air can trigger heart attacks, strokes, arrhythmias and heart failure, especially among the elderly and those with preexisting health conditions. Long-term exposure further increases the risk of death, he added.
Okuyan noted that certain countries experience particularly high levels of air pollution-related heart disease. “In China, industrial pollution, heavy traffic and coal use result in millions of deaths from cardiovascular disease each year. In India, the use of solid fuels causes both indoor and outdoor air pollution, leading to high rates of heart attacks and strokes. Pakistan, with air quality far below global standards, sees a rise in cardiovascular disease due to smoke from industry and transportation:
He continued, "In Nigeria, traffic and poor fuel quality have doubled air pollution over the past 20 years, increasing heart disease incidence. In Egypt, traffic, industry and desert dust make cardiovascular disease a leading cause of death. Protecting the environment is directly protecting our hearts.”
Okuyan also emphasized the strong connection between extreme weather events, such as heatwaves, storms and floods caused by climate change and cardiovascular health.
“In very hot weather, the body works harder to cool itself, heart rate increases, blood pressure may drop, and blood can thicken. In cold weather, blood vessels constrict, blood pressure rises and the heart works harder. Older adults, patients with high blood pressure and people with heart disease are especially vulnerable. Avoiding the hottest hours in summer, dressing warmly in winter and maintaining hydration are crucial,” he advised.
Noise and light pollution also negatively affect heart health. Noise increases stress hormones, raises blood pressure and can disturb heart rhythm, while light pollution disrupts sleep and increases the risk of heart disease in people who cannot get quality rest.
Microplastics, described by Okuyan as “a danger circulating inside our blood vessels,” also pose a significant risk. Studies have found microplastics in arterial plaques of patients who underwent heart surgery, with these individuals facing approximately 4.5 times higher risk of heart attack, stroke and death in subsequent years.
To protect heart health, Okuyan recommends avoiding outdoor activity on highly polluted days, using air purifiers indoors, reducing single-use plastic consumption and managing stress through walking or other exercises. He stressed that individual changes combined with societal awareness can greatly reduce cardiovascular risks,
“Preventing heart disease actually begins on the streets. Clean air, clean water and orderly living spaces reduce cardiovascular diseases. Small individual actions can play a very large role in protecting public health,” he added.
