Cardiovascular disease in low- and middle-income countries associated with environmental factors

Contribution of laboratory medicine and emerging technologies to cardiovascular risk reduction via exposome analysis: an opinion of the IFCC Division on Emerging Technologies

This opinion article highlights the critical role of laboratory medicine and emerging technologies in cardiovascular risk reduction through exposome analysis. The exposome encompasses all external and internal exposures an individual faces throughout their life, influencing the onset and progression of cardiovascular diseases (CVD). Integrating exposome data with genetic information allows for a comprehensive understanding of the multifactorial causes of CVD, facilitating targeted preventive interventions. Laboratory medicine, enhanced by advanced technologies such as metabolomics and artificial intelligence (AI), plays a pivotal role in identifying and mitigating these exposures. Metabolomics provides detailed insights into metabolic changes triggered by environmental factors, while AI efficiently processes complex datasets to uncover patterns and associations. This integration fosters a proactive approach in public health and personalized medicine, enabling earlier detection and intervention. The article calls for global implementation of exposome technologies to improve population health, emphasizing the need for robust technological platforms and policy-driven initiatives to seamlessly integrate environmental data with clinical diagnostics. By harnessing these innovative technologies, laboratory medicine can significantly contribute to reducing the global burden of cardiovascular diseases through precise and personalized risk mitigation strategies.

Silent threats of lead-based paints in toys and households to children's health and development

Lead (Pb), a highly toxic heavy metal, poses a significant global health risk, particularly to children. Widely used in paint manufacturing for its remarkable corrosion-resistance properties Pb exposure has been linked to severe health issues, including reduced neurotransmitter levels, organ damage, potentially leading to death in extreme cases. Children Are particularly vulnerable, with Pb toxicity primarily affecting the brain, reproductive, kidneys, and cardiovascular systems. Approximately 0.6 million children worldwide suffer from cognitive impairments caused by Pb exposure. Despite varying Pb content regulations across countries, research has found that Pb concentration in paints often exceed permissible levels. A 0.01 mg/dL blood Pb level (BLL) is considered the threshold level as per the World Health Organization. However, recent studies reveal that significant health effects, including cognitive impairments in children, occur even at BLLs < 0.01 mg/dL. This review provides critical insights into the global production and use of Pb-based paints, release mechanisms of Pb, exposure pathways, and safety standards. It also highlights the harmful effects of Pb on human health, particularly in children, and its detailed toxicity mechanisms. Finally, this review identifies critical knowledge gaps and offers perspectives for future research.

Global Health Inequities in Electrophysiology Care: A State-of-the-Art Review

This state-of-the-art review examines disparities in the diagnosis, management, and outcomes of cardiac arrhythmias globally. These arrhythmias include atrial fibrillation, ventricular tachyarrhythmias underlying sudden cardiac death, and bradyarrhythmias associated with sinus node and atrioventricular node disease. Arrhythmias in low- and middle-income countries often result in higher mortality rates due to complex and poorly documented risk factors, lack of clinical expertise among health care personnel, lack of sufficient infrastructure, and challenges in access to care. Innovative approaches like repurposing pacemakers, mobile clinics, use of digital technology, and training initiatives are being explored to address these issues. This article highlights the importance of diagnosis of arrhythmias in varying resource settings, access to care in those settings, and ongoing efforts to expand access to care.

The Impact of Air Pollution on Cardiovascular Health Outcomes in African Populations: A Scoping Review

Background

Air pollution is a significant environmental risk factor for cardiovascular diseases (CVDs), but its impact on African populations is under-researched due to limited air quality data and health studies.

Objectives

The purpose of this study was to synthesize available research on the effects of air pollution on CVDs outcomes in African populations, identify knowledge gaps, and suggest areas for research and policy intervention.

Methods

A systematic search of PubMed was conducted using terms capturing criteria ambient air pollutants (for example particulate matter, nitrogen dioxide, ozone, and sulfur dioxide) and CVDs and countries in Africa. Exclusions were studies on tobacco smoking, household air pollution, and occupational exposures.

Results

Six studies met the full inclusion criteria. Most studies were conducted in urban settings and most investigated on particulate matter, nitrogen dioxide and sulfur dioxide. Five of the 6 studies were performed in South Africa. The studies showed positive associations between exposure to air pollutants and increased incidence of stroke and overall cardiovascular hospitalization and mortality. However, there was considerable variation in study design, pollutant measurement methods, and adjustment for confounders.

Conclusions

This review highlights a critical need for standardized research on air pollution and cardiovascular health in Africa. The extremely limited numbers of studies make it difficult to ascertain the true impact of air pollution across the African continent. Future research should include longitudinal studies in different African populations with standardized methods. There is an urgent need to improve pollution monitoring networks, ascertain key sources of exposure, and implement air quality standards.