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Air Pollution and Exposomic Impacts on Heart Failure
Lavanya Bellumkonda1, Tasveer Khawaja2, Sadeer Al-Kindi3
1Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (L.B.).
Circulation. Heart Failure
|December 5, 2025
Summary
Air pollution significantly drives heart failure development and worsening. This review synthesizes evidence on air pollution
Area of Science:
- Environmental Health
- Cardiovascular Medicine
- Public Health
Background:
- Air pollution is a leading global environmental health risk factor for cardiovascular disease.
- Emerging evidence highlights air pollution's role in heart failure pathogenesis, progression, and prognosis.
- Air pollution is recognized as part of the exposome, encompassing life-course environmental, social, and behavioral exposures.
Purpose of the Study:
- To synthesize mechanistic, experimental, clinical, and epidemiological evidence linking air pollution to heart failure.
- To examine interactions between air pollution and other exposomic factors exacerbating heart failure risk.
- To propose strategies for risk communication, mitigation, and clinical management of air pollution exposure in heart failure patients.
Main Methods:
- Review of experimental data on mechanistic links between air pollution and heart failure.
- Synthesis of experimental, clinical, and epidemiological studies on air pollution exposure and heart failure progression.
- Analysis of air pollution's interaction with social and environmental exposomic factors.
Main Results:
- Experimental data demonstrate mechanistic pathways connecting air pollution to heart failure.
- Both short- and long-term air pollution exposure are linked to increased heart failure progression.
- Air pollution exacerbates vulnerability, particularly in marginalized populations, through interactions with other exposomic domains.
Conclusions:
- Air pollution is a critical, modifiable risk factor in heart failure.
- Understanding exposomic interactions is crucial for addressing health disparities in heart failure.
- Clinical frameworks are needed for assessing and managing air pollution exposure in heart failure patients to mitigate cardiovascular impact.
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