EAPC Quiz: Environmental Factors and Cardiovascular Risk

17 June 2025

Organised by:

reviewed by Monica Tiberi

The case

A 65-year-old woman attends a preventive cardiology visit with concerns about her cardiovascular risk. She has a history of well-controlled hypertension and lives near a major roadway in an urban area. She reports frequent exposure to air pollution and traffic noise, and notes that she feels more fatigued during hot weather. Her physical exam and basic labs are within normal limits, apart from mildly elevated LDL cholesterol. She is seeking advice on whether and how her living environment might have an impact on her cardiovascular risk.

References

Question 1: Motairek I, Ajluni S, Khraishah H, AlAhmad B, Al-Dulaimi S, Abi Khalil C, Rajagopalan S, Al-Kindi S. Burden of cardiovascular disease attributable to particulate matter pollution in the eastern Mediterranean region: analysis of the 1990-2019 global burden of disease. Eur J Prev Cardiol. 2023 Feb 14;30(3):256-263. doi: 10.1093/eurjpc/zwac256. PMID: 36321426.

Question 2: Poulsen AH, Sørensen M, Hvidtfeldt UA, Ketzel M, Christensen JH, Brandt J, Frohn LM, Massling A, Khan J, Münzel T, Raaschou-Nielsen O. Concomitant exposure to air pollution, green space and noise, and risk of myocardial infarction: a cohort study from Denmark. Eur J Prev Cardiol. 2024 Jan 5;31(1):131-141. doi: 10.1093/eurjpc/zwad306. PMID: 37738461.

Question 3: Yang Y, Cao L, Xia Y, Li J. The effect of living environmental factors on cardiovascular diseases in Chinese adults: results from a cross-sectional and longitudinal study. Eur J Prev Cardiol. 2023 Aug 21;30(11):1063-1073. doi: 10.1093/eurjpc/zwac304. PMID: 36537654.

Question 4: Jiang Z, Zhang S, Gao T, et al. Co-exposure to multiple air pollutants, genetic susceptibility, and the risk of myocardial infarction onset: a cohort analysis of the UK Biobank participants. Eur J Prev Cardiol. 2024;31(6):698–706. doi:10.1093/eurjpc/zwad384.

Question 5: Cheng YJ, Zhu C, Deng H, et al. Air Pollution, Genetic Susceptibility, and the Risk of Ventricular Arrhythmias: A prospective cohort study in the UK Biobank. Eur J Prev Cardiol. 2024 Dec 7:zwae390. doi:10.1093/eurjpc/zwae390.