The Impact of Air Pollution on Cardiovascular Health: Insights from Experts

New Delhi: Air pollution is increasingly recognized as a significant risk factor for cardiovascular disease, contributing to a global public health crisis. Fine particulate matter (PM2.5), nitrogen dioxide (NO2), and other pollutants have been linked to the development and worsening of conditions such as heart attacks, stroke, and chronic heart failure. Prolonged exposure to these harmful substances can lead to inflammation, oxidative stress, and vascular damage, ultimately compromising heart health. In this article, experts weigh in on the latest research, sharing insights on how air pollution affects cardiovascular health and offering guidance on preventive measures to mitigate its impact.

Dr Lal Daga - MBBS, DNB (Med.), DNB (Card) MNAMS, FESC (International), FEAC, Advanced Cardiology Training Programme (Seoul), Senior Consultant Interventional Cardiologist at Apollo Hospital, Ahmedabad

Air pollution poses a significant and often underestimated risk to cardiovascular health. Fine particulate matter (PM2.5) and harmful gases like nitrogen dioxide and carbon monoxide can lead to systemic inflammation, oxidative stress, and even blood clot formation, which are precursors to heart attacks and strokes.Dr Lal Daga an interventional cardiologist at Apollo hospital, Ahmedabad has seen a worrying rise in cases of heart disease that may be linked to prolonged exposure to polluted air  in few cases also as now few studies have established the association between pollutants and vascular inflammation. That’s why it is crucial for individuals to minimize their exposure by using air purifiers at home if possible, wearing masks in high-pollution areas, and avoiding outdoor activities during peak pollution hours. On a larger scale, policies aimed at reducing vehicular emissions and promoting green spaces are critical. Protecting our heart health begins with addressing the environment also we live in.”

Dr Lal Daga has re-emphasised the importance of pure air in preventing many diseases as we know the basic requirement to live is water, air and food. Any contamination in these basic requirement opens the plethora of risk factors to health disorders & illnesses.

Dr Ravikant Patil, Interventional Cardiologist

Air pollution is a critical and growing threat to cardiovascular health, with rising global concerns over its impact. Harmful pollutants, such as fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), can be inhaled into the lungs and enter the bloodstream, causing widespread damage. Prolonged exposure to these pollutants has been linked to increased risks of high blood pressure, heart attacks, strokes, and chronic heart disease. Of particular concern is PM2.5, which can penetrate deeply into blood vessels, triggering inflammation and oxidative stress, leading to plaque formation and arterial hardening. For individuals with existing heart conditions, air pollution can exacerbate symptoms and contribute to complications like arrhythmias and heart failure. Urban and industrial areas see higher levels of exposure, placing vulnerable populations—such as the elderly, children, and those with pre-existing conditions—at greater risk. Mitigating these effects requires stricter emission controls, cleaner energy alternatives, and increased public awareness of the dangers of air pollution.

Dr S S Murthy, Director & HOD – Cardiology, Ayushman Hospital and Health Services, New Delhi

Air pollution has a significant impact on cardiovascular health, increasing the risk of heart attacks, strokes, and indirect damage through lung impairment. It affects both short-term and long-term health. In the short term, pollutants like PM2.5 and PM10 particles penetrate blood vessels, causing oxidation and vessel damage, leading to reduced blood flow to vital organs, including the heart. Increased nitrogen dioxide and decreased oxygen levels also constrict blood vessels, further compromising circulation. Long-term exposure leads to atherosclerosis, where plaques form in blood vessels, restricting blood flow and increasing the risk of heart attacks and strokes. Repeated heart stress can result in structural changes to the heart, reducing its function and increasing the risk of heart failure and sudden cardiac arrest. Vulnerable groups, including the elderly, children, and those with pre-existing heart conditions, are at heightened risk. Preventive measures include using air purifiers, wearing masks, and adopting clean energy practices alongside a healthy lifestyle.

Prof. (Dr) M. Wali, MD FRCP FACC (USA), Sir Ganga Ram Hospital, New Delhi

Cardiovascular disease (CVD) remains the leading cause of death worldwide, though significant progress in high-income countries has reduced its prevalence through better control of risk factors like smoking, hypertension, and diabetes. However, low- and middle-income countries continue to bear a heavy CVD burden, despite lower traditional risk factors. Environmental factors, particularly air pollution, are a significant contributor to this disparity. Emerging evidence highlights a strong link between air pollution and adverse cardiovascular outcomes. Both short- and long-term exposure to pollutants, especially PM2.5, increase morbidity and mortality, often amplifying the effects of other risk factors. Clinicians must consider air quality when assessing cardiovascular risk. Air pollution, both outdoor and indoor, exacerbates heart disease across all demographics, particularly impacting the elderly, children, and those with pre-existing conditions. Reducing pollution exposure and improving air quality standards are critical to addressing this growing public health issue.

Dr Abhinit Gupta- MD, DM (AIIMS, Delhi) Gold Medalist, FIACM, FSCAI, Senior Consultant Interventional Cardiologist at Regency Health, Kanpur

Air pollution has significant adverse effects on cardiovascular health. Long-term exposure to pollutants, such as particulate matter, nitrogen dioxide, carbon monoxide, sulfur dioxide and ozone, can increase the risk of heart disease and exacerbate existing conditions.  Air pollution can Increased Risk of Heart Disease like Atherosclerosis, coronary artery disease, Exacerbation of Existing Cardiovascular Conditions, Heart Failure & arrhythmias, Increased Blood Pressure, Inflammation and Oxidative Stress, Increased Risk of Stroke, Impact on Vulnerable Populations including few Acute Effects. Air pollution is a major risk factor for cardiovascular health. Long-term exposure to various air pollutants can lead to the development of heart disease, exacerbate existing cardiovascular conditions, and increase the risk of stroke. Reducing exposure to air pollution, particularly in urban areas, can help mitigate these risks and improve overall cardiovascular health.

Dr Bipin Chandra Aditya Dasari - Interventional Cardiologist at Rhythm Heart Institute, Vadodara

"Air pollution is an invisible but significant threat to cardiovascular health. The fine particulate matter (PM2.5) and harmful gases like nitrogen dioxide can trigger inflammation in blood vessels, leading to a higher risk of hypertension, heart attacks, and strokes. As an interventional cardiologist, I see an increasing number of cases where environmental factors like poor air quality exacerbate underlying heart conditions. It's crucial for individuals to take preventive measures, such as wearing masks in high-pollution areas, using air purifiers at home, and limiting outdoor activities during peak pollution hours. On a broader level, we need stricter policies to curb emissions and promote greener practices. Protecting our air quality is not just about the environment—it’s about saving lives and ensuring a healthier future for all." – Dr. Bipin Chandra Aditya Dasari.

Dr Prabhakar C Koregol, DM - Cardiology, MD - General Medicine, MBBS, Interventional Cardiologist

Air pollution has a significant impact on cardiovascular health, contributing to many serious conditions, including and not limited to increased risk of heart attacks and stroke, high blood pressure, heart failure, irregular heartbeats and many other conditions. Approximately 20% of all cardiovascular disease deaths are attributable to air pollution.  The pathophysiology being predominantly contributed by PM2.5 and PM10 (Particulate Matter) and also contributed by Ozone and Nitrogen Dioxide. The impact can substantially reduce with monitoring air quality, reducing exposure, use of air purifiers and clean air policies.

Dr Gurbeer Singh Gill, MBBS, MD (Medicine), DM (Cardiology), M.Sc Diabetics (U.K), Punjab

Air pollution poses a significant threat to cardiovascular health, increasing the risk of heart disease, stroke, and cardiac arrhythmias. Exposure to particulate matter, nitrogen dioxide, and ozone triggers inflammation, damaging blood vessels and cardiac tissue. This exacerbates conditions like hypertension, atherosclerosis, and cardiac failure, leading to increased morbidity and mortality. Studies have shown that long-term exposure to poor air quality can lead to cardiovascular events, hospitalizations, and even death. Moreover, vulnerable populations such as the elderly, children, and those with pre-existing conditions are disproportionately affected. Reducing air pollution through sustainable practices and policies is crucial to mitigating its devastating impact on cardiovascular health and promoting a healthier future.

Dr Abdul Mansoor, Interventional Cardiologist, Mangalore

Dr. Abdul Mansoor, a renowned cardiologist, emphasizes that air pollution is a silent yet significant threat to cardiovascular health, contributing to increased risks of heart attacks, strokes, and other heart diseases. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) are particularly harmful as they promote inflammation, oxidative stress, and vascular dysfunction. Individuals with pre-existing heart conditions or hypertension are especially at risk of these adverse effects. To reduce these risks, Dr. Mansoor advises adopting protective measures, such as avoiding outdoor activities during high pollution hours, using air purifiers indoors, and supporting stricter regulations on industrial and vehicular emissions. He underscores that public awareness and a collective effort involving policymakers, healthcare professionals, and communities are vital to addressing this escalating public health concern effectively.”

Dr Kumar Gaurav Sharma, MBBS. MD Physician Consultant Preventive Medicine & Cardiology. DG Shipping& DGCA Approved, Graphic Era Hospital & Care Clinic Dehradun

Air pollution is a hidden threat to heart health, causing problems like high blood pressure, irregular heartbeats, heart attacks, and strokes. Harmful particles in the air, like PM2.5, and gases such as carbon monoxide can enter the bloodstream, leading to inflammation and damage to blood vessels,” explains Dr. Kumar Gaurav Sharma. Care Clinic Dehradun

He further adds, “People with heart conditions should take precautions, like staying indoors when pollution levels are high, using air purifiers, and wearing masks outdoors. On a larger scale, we need collective efforts to reduce pollution by using cleaner energy sources and planting more trees. Protecting the air we breathe is key to protecting our hearts. Dr Kumar Gaurav Sharma Care Clinic Dehradun.

Dr Dhiman Kahali, Director of Interventional Cardiology, Kolkata

Air pollution is an insidious threat to cardiovascular health, affecting millions worldwide. Prolonged exposure to pollutants, such as particulate matter and nitrogen dioxide and sulfur dioxide triggers systemic inflammation, oxidative stress, and endothelial dysfunction, ultimately leading to heart diseases. As the Director of Interventional Cardiology at BM Birla Heart Research Centre, I have witnessed an alarming rise in cases of coronary artery disease among younger patients, many of whom live in high-pollution areas. Mitigating this risk requires a multi-pronged approach—improving air quality, raising public awareness, and early detection of cardiovascular risks. Advances in interventions, including angioplasties and peripheral vascular treatments, can address the damage caused, but prevention remains paramount importance. Air pollution is not just an environmental issue; it’s a public health emergency. We must act decisively to protect the heart health of future generations.

Dr Ram Chandra Sherawat, Cardiothoracic and Vascular Surgeon, Jaipur

Air pollution has a significant impact on cardiovascular health and disease it contains many toxic, harmful tiny particles ,those pollutant particles directly enter to the lungs and blood stream when we breath, after entered in blood stream it can makes damage or inflamed blood vessels, those damage blood vessels become stiff and narrow that can lead to the higher blood pressure, coronary artery blockages, heart attack and stroke, it can affect the brain, heart and blood vessels. Pollutants makes blood stickier, increasing the chance of blood clots and , Stiffning of blood vessels makes harder to blood flow and over time , the heart works harder to pump blood, which can weaken it and lead to condition like heart failure. Protecting yourself with mask and staying indoors during high pollution days and supporting clean air initiatives which helps to protect cardiovascular health during high air pollution.