Smogged arteries, sneaky killers

This editorial highlights a groundbreaking study by Enyo Tong and colleagues, published in Atherosclerosis, which examines the global burden of ischemic heart disease (IHD) linked to ambient fine particulate matter (PM2.5) pollution from 1990 to 2021, with projections extending to 2072. Using data from the Global Burden of Disease 2021, the study reveals that middle-income countries, men, and older adults are disproportionately affected. The editorial emphasizes the growing recognition of PM2.5 as a major cardiovascular risk factor-its impact by 2025 is expected to rival that of smoking. It revisits foundational research, including the Harvard Six Cities Study and subsequent influential publications, which established the link between air pollution and heart disease. Key sources of PM2.5 include vehicle emissions, industrial activity, fossil fuel combustion, agriculture, household pollutants, and natural events-most of which are shaped by human behavior and policy. The editorial calls for urgent action to reduce both outdoor and indoor air pollution, integrate pollution-related cardiovascular risks into medical education, and push policymakers to address not only domestic but also cross-border pollution threats.