Links between Air Pollution and Aortic Diseases: Current Evidence for Future Prevention and Treatment

This review examines the evidence linking air pollution, particularly fine particulate matter (PM2.5), to aortic diseases such as atherosclerosis, aneurysms, and dissections. Air pollution is a significant environmental risk factor for cardiovascular disease, and understanding its impact on the aorta is crucial for developing prevention strategies. We performed a comprehensive literature search of PubMed for articles published between December 2007 and May 2024, including in vivo, in vitro, and clinical studies that investigate the effects of air pollution on aortic pathophysiology. Findings indicate that exposure to PM2.5 and diesel exhaust particles accelerates aortic atherosclerosis, aneurysm formation, and dissection through mechanisms involving oxidative stress, inflammation, endothelial dysfunction, and vascular remodelling, with heightened effects in genetically predisposed models and high-fat diets. In vitro studies reveal that particles can cause cytotoxicity in human aortic endothelial cells, characterized by reduced nitric oxide production and cellular damage. Clinical data are mixed but suggest associations between air pollution and increased aortic calcification, arterial stiffness, and altered hemodynamics. Overall, air pollution influences the development and progression of aortic diseases via multiple biological pathways, emphasizing the need for further research to define dose-response relationships, identify molecular targets, and implement environmental interventions to reduce disease burden and protect public health.