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Wei Y, Feng Y, Danesh Yazdi M, Yin K, Castro E, Shtein A, Qiu X, Peralta AA, Coull BA, Dominici F, Schwartz JD. Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: population based cohort study. BMJ 2024; 384:e076939. [PMID: 38383041 PMCID: PMC10879983 DOI: 10.1136/bmj-2023-076939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To estimate exposure-response associations between chronic exposure to fine particulate matter (PM2.5) and risks of the first hospital admission for major cardiovascular disease (CVD) subtypes. DESIGN Population based cohort study. SETTING Contiguous US. PARTICIPANTS 59 761 494 Medicare fee-for-service beneficiaries aged ≥65 years during 2000-16. Calibrated PM2.5 predictions were linked to each participant's residential zip code as proxy exposure measurements. MAIN OUTCOME MEASURES Risk of the first hospital admission during follow-up for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, valvular heart disease, thoracic and abdominal aortic aneurysms, or a composite of these CVD subtypes. A causal framework robust against confounding bias and bias arising from errors in exposure measurements was developed for exposure-response estimations. RESULTS Three year average PM2.5 exposure was associated with increased relative risks of first hospital admissions for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms. For composite CVD, the exposure-response curve showed monotonically increased risk associated with PM2.5: compared with exposures ≤5 µg/m3 (the World Health Organization air quality guideline), the relative risk at exposures between 9 and 10 µg/m3, which encompassed the US national average of 9.7 µg/m3 during the study period, was 1.29 (95% confidence interval 1.28 to 1.30). On an absolute scale, the risk of hospital admission for composite CVD increased from 2.59% with exposures ≤5 µg/m3 to 3.35% at exposures between 9 and 10 µg/m3. The effects persisted for at least three years after exposure to PM2.5. Age, education, accessibility to healthcare, and neighborhood deprivation level appeared to modify susceptibility to PM2.5. CONCLUSIONS The findings of this study suggest that no safe threshold exists for the chronic effect of PM2.5 on overall cardiovascular health. Substantial benefits could be attained through adherence to the WHO air quality guideline.
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Affiliation(s)
- Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Yijing Feng
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Kanhua Yin
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Alexandra Shtein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Adjani A Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kuntic M, Kuntic I, Hahad O, Lelieveld J, Münzel T, Daiber A. Impact of air pollution on cardiovascular aging. Mech Ageing Dev 2023; 214:111857. [PMID: 37611809 DOI: 10.1016/j.mad.2023.111857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/19/2023] [Indexed: 08/25/2023]
Abstract
The world population is aging rapidly, and by some estimates, the number of people older than 60 will double in the next 30 years. With the increase in life expectancy, adverse effects of environmental exposures start playing a more prominent role in human health. Air pollution is now widely considered the most detrimental of all environmental risk factors, with some studies estimating that almost 20% of all deaths globally could be attributed to poor air quality. Cardiovascular diseases are the leading cause of death worldwide and will continue to account for the most significant percentage of non-communicable disease burden. Cardiovascular aging with defined pathomechanisms is a major trigger of cardiovascular disease in old age. Effects of environmental risk factors on cardiovascular aging should be considered in order to increase the health span and reduce the burden of cardiovascular disease in older populations. In this review, we explore the effects of air pollution on cardiovascular aging, from the molecular mechanisms to cardiovascular manifestations of aging and, finally, the age-related cardiovascular outcomes. We also explore the distinction between the effects of air pollution on healthy aging and disease progression. Future efforts should focus on extending the health span rather than the lifespan.
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Affiliation(s)
- Marin Kuntic
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany
| | - Ivana Kuntic
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany
| | - Omar Hahad
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Atmospheric Chemistry, Mainz, Germany
| | - Thomas Münzel
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany.
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Sivakumar B, Kurian GA. Mitochondria and traffic-related air pollution linked coronary artery calcification: exploring the missing link. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:545-563. [PMID: 34821115 DOI: 10.1515/reveh-2020-0127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/04/2021] [Indexed: 06/13/2023]
Abstract
The continuing increase in the exposure to Traffic-related air pollution (TRAP) in the general population is predicted to result in a higher incidence of non-communicable diseases like cardiovascular disease. The chronic exposure of air particulate matter from TRAP upon the vascular system leads to the enhancement of deposition of calcium in the vasculature leading to coronary artery calcification (CAC), triggered by inflammatory reactions and endothelial dysfunction. This calcification forms within the intimal and medial layers of vasculature and the underlying mechanism that connects the trigger from TRAP is not well explored. Several local and systemic factors participate in this active process including inflammatory response, hyperlipidemia, presence of self-programmed death bodies and high calcium-phosphate concentrations. These factors along with the loss of molecules that inhibit calcification and circulating nucleation complexes influence the development of calcification in the vasculature. The loss of defense to prevent osteogenic transition linked to micro organelle dysfunction that includes deteriorated mitochondria, elevated mitochondrial oxidative stress, and defective mitophagy. In this review, we examine the contributory role of mitochondria involved in the mechanism of TRAP linked CAC development. Further we examine whether TRAP is an inducer or trigger for the enhanced progression of CAC.
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Affiliation(s)
- Bhavana Sivakumar
- Vascular Biology Lab, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, India
| | - Gino A Kurian
- Vascular Biology Lab, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, India
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4
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Pang Y, Liu S, Yan L, Wang Q, Li L, Chu C, Ning J, Zhang B, Wang X, Ma S, Su D, Zhang R, Niu Y. Associations of long-term exposure to traffic-related air pollution with risk of valvular heart disease based on a cross-sectional study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 209:111753. [PMID: 33348255 DOI: 10.1016/j.ecoenv.2020.111753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/13/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Emerging evidence demonstrated that traffic-related air pollution induced adverse effects on cardiovascular system. We designed a population-based cross-sectional study to explore the association between residential proximity to major roadways, traffic density and the prevalence of valvular heart disease (VHD). A total of 34040 subjects from a Rural Health Project between 2013 and 2018 were collected. According to the inclusion and exclusion criteria, 4158 participants were enrolled in the final analysis. And we calculated the subjects' proximity to major roadways and collected the traffic density on the major roadways. Transthoracic echocardiography (TTE) was performed to diagnose the VHD, according to the current AHA/ACC (the American Heart Association and the American College of Cardiology) guidelines. Differences between groups were examined by the one-way ANOVAs for continuous variables and the chi-square tests for categorical variables. A logistic regression models were used to assess the associations. The stratified analysis by age and sex were conducted to further analyze the association. The restricted cubic spline analysis was performed to further evaluate the association between road way distance and VHD. Bonferroni test was used to adjust the significance level. The subjects closer to the major roads had the higher risk of tricuspid regurgitation (TR) (odds risk, OR = 1.519, 95% confidence intervals, 95%CI: 1.058-2.181), especially in female. The risk of VHD was positive (high traffic density VS low traffic density, OR = 1.799, 95%CI: 1.221-2.651), especially in female. In addition, the high traffic density was associated with the risk of mitral regurgitation (MR) (OR = 1.758, 95%CI: 1.085-2.848). The restricted cubic spline analysis found a threshold distance of about 300 m, where had the lowest risk of VHD, aortic regurgitation (AR), MR, TR. Our results found a positive association between traffic-related air pollution and VHD especially in female.
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Affiliation(s)
- Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China; Department of Health Management and Services, Cangzhou Medical College, Cangzhou 061000, People's Republic of China
| | - Shipeng Liu
- Experimental Center, Hebei Medical University, Shijiazhuang 050017, Hebei, People's Republic of China
| | - Lina Yan
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Qian Wang
- Experimental Center, Hebei Medical University, Shijiazhuang 050017, Hebei, People's Republic of China
| | - Lipeng Li
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Chen Chu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Jie Ning
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Boyuan Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Xueliang Wang
- Deportment occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Shitao Ma
- Deportment occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Dong Su
- Deportment occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China; Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang 050017, People's Republic of China.
| | - Yujie Niu
- Deportment occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, People's Republic of China; Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang 050017, People's Republic of China
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5
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Krupnova TG, Rakova OV, Gavrilkina SV, Antoshkina EG, Baranov EO, Yakimova ON. Road dust trace elements contamination, sources, dispersed composition, and human health risk in Chelyabinsk, Russia. CHEMOSPHERE 2020; 261:127799. [PMID: 32739694 DOI: 10.1016/j.chemosphere.2020.127799] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/08/2020] [Accepted: 07/21/2020] [Indexed: 05/11/2023]
Abstract
There are many sources of urban road dust, such as soil dispersal, emissions of industrial enterprises and thermal power plants, road traffic-related processes. Chelyabinsk was selected as a typical Russian industrial city. This work was the first pollution study of road dust in Chelyabinsk. We examined 125 road dust samples were on the content toxic trace elements (As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Sr, and Zn). The concentrations of trace elements in road dust were determined using ICP-MS. Results showed that the metal concentrations in dust were higher than the background value of local soil. The distribution curves of dust were asymmetric, had have two peaks, and showed significant unimodal distribution. The higher share of particles was in the range from 30 … 40 to 250 … 300 μm. The thoracic fraction volume (%) and concentrations of trace elements were higher near metallurgical plants. Cadmium, Сu, Mn, Ni, Sr, Pb and Zn were originated from industry and transport; electrometallurgical plant was source of Cr; Al, Co, and Fe derived from local soils and pavement erosion; As, Hg and Sb were the tracers of coal-fired power stations emission. Ingestion was a major exposure way of toxic elements in the dust. The results suggested that there was no significant potential health risk to both children and adults from exposure to any elements in road dust. The cancer risk for adults and children from exposure to As, Cd, Cr, and Pb was found to be at the acceptable or tolerable level. The study deals with the contamination of potentially toxic trace elements (As, Cd, Co, Cr, Cu, Mn, Ni, Pb, Sb, Sr and Zn) in road dust collected from Chelyabinsk urban area.
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Affiliation(s)
- Tatyana G Krupnova
- Chemistry Department, South Ural State University, 454080, Chelyabinsk, Russian Federation.
| | - Olga V Rakova
- Chemistry Department, South Ural State University, 454080, Chelyabinsk, Russian Federation
| | - Svetlana V Gavrilkina
- South Urals Federal Research Center of Mineralogy and Geoecology of the Urals Branch of the Russian Academy of Sciences, Ilmen Reserve, 456317, Miass, Russian Federation
| | - Elizaveta G Antoshkina
- Chemistry Department, South Ural State University, 454080, Chelyabinsk, Russian Federation
| | - Evgeny O Baranov
- Chemistry Department, South Ural State University, 454080, Chelyabinsk, Russian Federation
| | - Olga N Yakimova
- Chemistry Department, South Ural State University, 454080, Chelyabinsk, Russian Federation
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6
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Hall KC, Robinson JC. Association between maternal exposure to pollutant particulate matter 2.5 and congenital heart defects: a systematic review. ACTA ACUST UNITED AC 2020; 17:1695-1716. [PMID: 31021973 DOI: 10.11124/jbisrir-2017-003881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this review was to determine if there was an association between maternal exposure to pollutant particulate matter 2.5 during the first trimester of pregnancy and congenital heart defects within the first year of life. INTRODUCTION The environment is recognized as an important determinant of health for both the individual and population. Air pollution specifically is a major environmental risk factor impacting health with links to asthma, heart disease, obesity, and fetal developmental complications. Of the commonly monitored air pollutants, particulate matter 2.5 has associations with health, especially among vulnerable populations such as children and pregnant women. A congenital heart defect is a fetal complication that impacts 34.3 million infants globally, with more than 80% of the diagnoses having an unknown etiology. Although environmental risk factors such as air pollution are thought to be a risk factor in the diagnosis of a congenital heart defect, epidemiologic research evidence is limited. INCLUSION CRITERIA This review considered studies that evaluated maternal exposure to the air pollutant particulate matter 2.5 during the first trimester (weeks 1-12) of fetal development. The primary outcome was a diagnosis of a congenital heart defect in an infant within the first year of life. METHODS A three-step search strategy was utilized in this review and included 11 databases and two websites. Studies published from January 2002 to September 2018 were eligible for inclusion. Only papers published in English were included. Eligible studies underwent critical appraisal by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from the included studies independently by two reviewers. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted for the individual outcome measures, specifically atrial septal defect, ventricular septal defect, and tetralogy of fallot, respectively. The defects were identified and pooled, where possible, in statistical meta-analysis. Where statistical pooling was not possible, findings were reported narratively. RESULTS Five studies were identified that met the inclusion criteria, including three cohort and two case-control designs. Each individual study identified at least one statistically significant increase or inverse association between particulate matter 2.5 and a congenital heart defect. An increased risk was identified with more than seven isolated and two groupings of congenital heart defects. An inverse risk was identified with two isolated and one grouping of congenital heart defects. Meta-analysis results were: atrial septal defect, OR = 0.65 (95% CI, 0.37 to 1.15); ventricular septal defect, OR = 1.02 (95% CI, 075 to 1.37); and tetralogy of fallot, OR = 1.16 (95% CI, 0.78 to 1.73), indicating no statistically significant findings. CONCLUSION There was no significant evidence to support an association between air pollutant particulate matter 2.5 and a congenital heart defect in the first year of life. However, few studies met the rigorous inclusion criteria, and the studies that did had high heterogeneity, making it difficult to complete a meta-analysis with such a limited number of articles. Further research is needed to standardize the outcomes and pollutant monitoring methods, and provide comparable analysis results so that future synthesis of the literature can be conducted.
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Affiliation(s)
- Katie C Hall
- School of Nursing, University of Mississippi Medical Center, Jackson, USA.,Mississippi Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence
| | - Jennifer C Robinson
- School of Nursing, University of Mississippi Medical Center, Jackson, USA.,Mississippi Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence
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Li Z, Ma J, Li X, Chan MTV, Wu WKK, Wu Z, Shen J. Aberrantly expressed long non-coding RNAs in air pollution-induced congenital defects. J Cell Mol Med 2019; 23:7717-7725. [PMID: 31557384 PMCID: PMC6815773 DOI: 10.1111/jcmm.14645] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/07/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022] Open
Abstract
Air pollution has been a serious public health issue over the past few decades particularly in developing countries. Air pollution exposure during pregnancy poses potential threat to offspring as the deleterious substances might pass through placenta to alter foetal development. A growing number of studies have demonstrated that long non-coding RNAs (lncRNAs) participate in the development of many diseases, including congenital defects. Here, we used RNA sequencing to identify differentially expressed lncRNAs in air pollution-exposed rat embryos compared with control group. Our data suggested that 554 lncRNAs (216 up-regulated and 338 down-regulated) were significantly differentially expressed in the air pollution-exposed embryos. Moreover, potential cellular functions of these deregulated lncRNAs were predicted via KEGG signal pathway/GO enrichment analyses, which suggested the possible involvements of neurological process, sensory perception of smell and the G-protein signalling pathway. Furthermore, potential functional network of deregulated lncRNAs and their correlated mRNAs in the development of congenital spinal abnormality was established. Our data suggested that lncRNAs may play a vital role in the pathophysiology of air pollution-exposed congenital spinal malformation.
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Affiliation(s)
- Zheng Li
- Department of Orthopaedic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jianqing Ma
- Department of Orthopedic SurgeryThe General Hospital of Xingtai Mining Industry Bloc.Orthopaedic Hospital of XingtaiXingtaiChina
| | - Xingye Li
- Department of Orthopedic SurgeryBeijing Jishuitan HospitalFourth Clinical College of Peking UniversityJishuitan Orthopaedic College of Tsinghua UniversityBeijingChina
| | - Matthew T. V. Chan
- Department of Anaesthesia and Intensive CareThe Chinese University of Hong KongHong KongChina
| | - William K. K. Wu
- Department of Anaesthesia and Intensive CareThe Chinese University of Hong KongHong KongChina
- State Key Laboratory of Digestive DiseasesLi Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong KongChina
| | - Zhanyong Wu
- Department of Orthopedic SurgeryThe General Hospital of Xingtai Mining Industry Bloc.Orthopaedic Hospital of XingtaiXingtaiChina
| | - Jianxiong Shen
- Department of Orthopaedic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Hu S, Belcaro G, Cesarone MR, Feragalli B, Cotellese R, Dugall M, Scipione C, Scipione V, Maione C. Central cardiovascular calcifications: supplementation with Pycnogenol® and Centellicum®: variations over 12 months. Minerva Cardioangiol 2019; 68:22-26. [PMID: 31633315 DOI: 10.23736/s0026-4725.19.05052-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This 'concept' registry study evaluated the efficacy of Pycnogenol® and the combination Pycnogenol® and Centella Asiatica (Centellicum®) in controlling over 12 months the increasing number of arterial/cardiac calcifications in subjects with asymptomatic atherosclerosis. METHODS The study included 3 groups of 30 males with asymptomatic coronary calcifications. Group one was followed with standard management (SM); group 2 used SM and Pycnogenol® (150 mg/day); group 3 used the combination Pycnogenol® (150 mg/day) + Centellicum® (450 mg/day). All subjects took cardioaspirin (Bayer, 100 mg/day). RESULTS No dropouts, no clinical events were observed in 12 months. The 3 groups had comparable demographic and medical characteristics at baseline. No tolerability problems and no side effects from supplementation were reported. After 12 months, oxidative stress was significantly decreased (P<0.05) in both groups taking Pycnogenol®. The evaluation of the number of calcifications >1 mm indicated a trend in controls using SM towards a progressive increase in calcifications. At 12 months the decrease in the number of calcifications with the combined supplements (Pycnogenol® and Centellicum®) (group 3) was -9.952% and thus significantly better that in the other two groups (P<0.05). Pycnogenol® alone was more effective than SM alone in controlling the variation in calcifications (P<0.05). Considering a 34.88% increase in SM subjects, the total absolute difference between SM (34.8%) and the decrease observed in group 3 (-9.95%) was 44.75% (P<0.02). This indicates that supplementation with the combined supplements blocks the increase in calcified areas and, possibly, in time may decrease the number of calcified spots. CONCLUSIONS This study shows that there is a significant activity of the complex Pycnogenol®+ Centellicum® in reducing the progressive diffusion of central cardiovascular calcifications-associated with advanced plaques - in a relatively short period of time. Longer studies - focusing also on events - may better evaluate the efficacy of these standardized supplements combination on the evolution of atherosclerosis.
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Affiliation(s)
- Shu Hu
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Gianni Belcaro
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy -
| | - Maria Rosaria Cesarone
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Beatrice Feragalli
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Roberto Cotellese
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Mark Dugall
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Claudia Scipione
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Valeria Scipione
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
| | - Claudia Maione
- IRVINE3 Labs, Department of Medical Oral and Biotechnological Sciences, Chieti-Pescara University, IAPSS, Pescara, Italy
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Tibuakuu M, Michos ED, Navas-Acien A, Jones MR. Air Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide. CURR EPIDEMIOL REP 2018; 5:370-378. [PMID: 30931239 DOI: 10.1007/s40471-018-0166-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose of review Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations. Recent findings Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations. Summary Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.
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Affiliation(s)
- Martin Tibuakuu
- St. Luke's Hospital, Department of Medicine, Chesterfield, MO, USA.,Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University School of Public Health, New York, NY, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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