Research that shows how air pollution can affect our hearts

BHF Professor David Newby

We’re leading the way in proving links between air pollution and heart disease. BHF Professor David Newby talks to Sarah Kidner.

“We can’t afford to be complacent,” says BHF Professor David Newby. He’s talking about the state of the air that we breathe every time we step outside. It’s not as fresh as you might think.

This is because diesel and petrol fumes pollute the air with ultra-fine nanoparticles. These stop blood vessels relaxing and contracting, which increases the risk of clots and heart attacks.

We know this thanks to more than a decade of research by Professor Newby and BHF Intermediate Research Fellow Nick Mills, both now based at our Edinburgh Centre of Research Excellence.

Professor Newby explains: “In the 1950s, when there was a lot of smog, the problem used to be that particles were big and they stuck in the upper airways. Now these nanoparticles go straight past, deep into the lungs, even into the bloodstream. We have a clear link between air pollution levels and heart attacks, and we believe the particles in the air are the cause of this.”

Understanding the risks

Pollution is a particular problem for the 570,000 people in the UK living with heart failure, shows a study by Professor Newby’s Edinburgh-based research team. The team analysed data from 12 countries covering more than four million people living with heart failure and found they had an increased risk of hospitalisation and death where pollution levels were high. “People with heart failure are a vulnerable group and, when the air quality falls, more of them are admitted to hospital,” says Professor Newby.

If you compare London with Beijing, there’s a huge difference in air quality

The question of risk varies worldwide, he explains. “If you compare London with Beijing, there’s a huge difference in air quality.

In Beijing, there are masses of particles in the air that are many times more prevalent than in most European cities. But even where air quality is relatively good, as in the UK, there is still a link with heart attacks and heart failure.”

Research released by the World Health Organization in March this year claims that one in eight of total global deaths is a result of air pollution exposure.

This more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. “Your risk if you are a healthy person is very, very small. It might be a one in a million chance of having a heart attack per day. However, on a population level, the risks are high,” he says.

Professor Newby and the team have been working with specialists in the Netherlands, Sweden and Beijing to see if reducing exposure to air pollution could benefit the heart and circulation.

Global co-operation

In Beijing, they organised local people with coronary heart disease (CHD) to walk around the city hooked up to portable blood pressure and heart rate monitors. Backpacks contained specialist equipment that measured their heart function and exposure to air pollutants. The team discovered that if volunteers wore a facemask to filter out the pollution particles, their blood pressure was lower and their heart activity was healthier.

We can’t afford to be complacent

That isn’t to say we should all rush out and buy facemasks, Professor Newby clarifies. “It might have a role if it’s a really bad pollution day and you have to go outdoors, but I am not encouraging the whole population to go out wearing a mask.”

However, he does recommend that those living with heart failure and CHD take caution.

“People with coronary heart disease, and particularly those with heart failure, should avoid spending long periods outdoors in areas where traffic pollution is likely to be high. Local air quality reports could help people understand when they might be most at risk.”

However, for most people, the benefits of exercising outdoors outweigh the risks associated with pollution. We’ll continue to fund research exploring the links between pollution and heart disease and we’ll lobby the Government to do the same. As Professor Newby says, “We can’t afford to be complacent.”

Policy explained: Air pollution levels in the UK are illegal

Air pollution levels in UKIn February this year the European Commission launched legal proceedings against the UK Government for failing to meet the deadline for reducing nitrogen dioxide emission after the European Supreme Court ruled that the UK was in breach of EU emission legislation.

Therefore we are calling on the UK Government and administrations around the UK to do all that they can, as quickly as they can, to reduce air pollution and protect the population, especially those with cardiovascular disease.

We are also calling on the Government to retain the legal duty on local authorities to monitor air quality in their area so the true extent of air pollution levels are recorded across the UK.

Air pollution reports

Air pollution reports The Department for Environment, Food and Rural Affairs provides air-quality information on its Air Information Resource website, UK-AIR. You can also find forecasts of air pollution over the next 24 hours for 16 regions of the UK, and 16 urban areas within them.

You can find information on Scotland’s air quality here. For Wales, check the Welsh Air Quality Forum. The Department of the Environment in Northern Ireland also has a website on air quality issues.

Centres of Research Excellence

BHF Professor Hugh WatkinsTotal funding to date awarded by the BHF and areas of special interest

£11.9m Imperial College: World-leading stem cell researcher BHF Professor Michael Schneider and his team hope to come up with ways to reverse the damage caused by heart failure. Read about the work of an Imperial PhD student in this field.

£15m King’s College London: This centre is making great strides in understanding the structure of the heart at a molecular level. One of our newest BHF Professors, Kinya Otsu from Japan, is researching new treatments for heart failure.

£3m University of Cambridge: BHF Professor Nick Morrell and his team are using innovative research approaches to find ways to prevent heart attacks.

£10.6m University of Edinburgh: Edinburgh’s Centre is identifying and exploring factors such as stress and exposure to air pollution, and the impact they may have on heart health, as our feature above explains.

£3m University of Glasgow: The funding will allow Glasgow scientists to investigate blood vessel damage that is caused by chronic conditions such as obesity and diabetes.

£14.4m University of Oxford: World-leading regenerative medicine specialists at Oxford, like Professor Hugh Watkins (pictured), are coming up with ways to repair damaged hearts.

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