Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis

Area of Science:

• Environmental Health
• Cardiovascular Research
• Epidemiology

Background:

• Vascular endothelial dysfunction is an early indicator of cardiovascular diseases (CVDs).
• The impact of air pollution exposure on endothelial function requires comprehensive epidemiological synthesis.
• Particulate matter (PM) and gaseous pollutants are suspected contributors to vascular impairment.

Approach:

• A systematic review and meta-analysis synthesized data from 34 articles (25 for meta-analysis) up to November 10, 2022.
• Fixed and random effect models quantified the association between air pollutants and vascular function metrics.
• Heterogeneity and publication bias were assessed using I² statistics, funnel plots, and Egger's test.

Key Points:

• Short-term exposure to PM2.5 (10 µg/m³ increment) significantly increased augmentation index (AIx) by 2.73% and pulse wave velocity (PWV) by 0.56%, while decreasing flow-mediated dilation (FMD) by 0.17%.
• Long-term PM2.5 exposure (10 µg/m³ increment) led to a 0.99% decrease in FMD.
• Associations with other pollutants were not statistically significant; PM2.5's effect on FMD was more pronounced in younger individuals, those with higher BMI, and higher exposure levels.

Conclusions:

• PM2.5 exposure adversely affects vascular endothelial function, highlighting its role in the early stages of CVD.
• Findings underscore the critical importance of air quality improvement for cardiovascular disease prevention strategies.
• Further research may explore the moderating effects of medication on air pollution's vascular impact.