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Respuestas respiratorias y cardiovasculares al caminar por una carretera contaminada por el tráfico en comparación
Rudy Sinharay1, Jicheng Gong2, Benjamin Barratt3
1National Heart and Lung Institute and MRC-PHE Centre for Environment and Health, Imperial College, London, UK; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK.
Lancet (London, England)
|December 10, 2017
Resumen
Caminar en áreas altamente contaminadas niega los beneficios del ejercicio para los pulmones y el corazón para los adultos mayores, incluidos aquellos con enfermedad pulmonar obstructiva crónica (EPOC) y enfermedad cardíaca isquémica. La exposición a la contaminación del tráfico perjudica las respuestas cardiopulmonares, lo que pone de relieve la necesidad de políticas de aire más limpio.
Área de la Ciencia:
- Salud del medio ambiente
- Medicina cardiopulmonar
- Gerontología
Sus antecedentes:
- La exposición a largo plazo a la contaminación atmosférica acelera el deterioro de la función pulmonar, especialmente en adultos mayores y pacientes con EPOC.
- Los altos niveles de contaminación a corto plazo están relacionados con el exceso de muertes cardíacas y exacerbaciones de EPOC.
Objetivo del estudio:
- Evaluar las respuestas respiratorias y cardiovasculares al caminar en una calle urbana altamente contaminada frente a un parque libre de tráfico en adultos mayores.
Principales métodos:
- Un estudio cruzado aleatorizado en el que participaron adultos mayores sanos, pacientes con EPOC y pacientes con cardiopatía isquémica.
- Los participantes caminaron durante 2 horas por la calle Oxford de Londres (alta contaminación) y el Hyde Park (baja contaminación).
- Las mediciones incluyeron las concentraciones de contaminantes atmosféricos (carbono negro, PM, NO2, partículas ultrafinas) y las respuestas fisiológicas (función pulmonar, velocidad de las ondas de pulso).
Principales resultados:
- Los niveles de contaminantes (carbono negro, NO2, PM, partículas ultrafinas) fueron significativamente más altos en la calle Oxford que en Hyde Park.
- Caminar en Hyde Park mejoró la función pulmonar (FEV1, FVC) y redujo los marcadores cardiovasculares (PWV, índice de aumento) en todos los participantes.
- Estos efectos beneficiosos se atenuaron después de caminar por Oxford Street, con un aumento de los síntomas respiratorios en los pacientes con EPOC.
- La exposición al NO2 y a las partículas ultrafinas en Oxford Street se asoció con cambios respiratorios y cardiovasculares adversos.
Conclusiones:
- La exposición a corto plazo a la contaminación del tráfico durante la caminata niega los beneficios cardiopulmonares del ejercicio en adultos mayores, incluidos aquellos con EPOC y enfermedad cardíaca isquémica.
- Las políticas de mitigación de la contaminación atmosférica son cruciales para proteger la salud pública, especialmente en entornos urbanos.
- La medicación puede mitigar algunos efectos adversos en pacientes con enfermedad cardíaca isquémica.
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