Summary

Although it is widely recognized that environmental factors such as smoking, diet, exercise, and socioeconomic status affect the risk of cardiovascular disease, recent work showing the effects of other environmental factors provides a more complete assessment of the situation. This view has emerged from three developments. Firstly, there has been a sudden explosion in the prevalence of diabetes and obesity which indicates a strong environmental component. Secondly, there is an accumulation of evidence suggesting that most cases of these diseases could be prevented by healthy lifestyle choices. Finally, studies have shown that exposure to environmental pollutants has a significant effect on heart disease risk. This book is the first to provide a comprehensive account of the effects of pollutants on heart disease and to integrate this area of research within the overall theme of environmental cardiology. The introductory chapter outlines the effects of different aspects of the environment on heart disease and provides a context for the discussion that follows. Subsequent chapters give an overview of the effects of particulate matter and discuss the epidemiological studies supporting the link. The book then goes on to cover the effects of pollution on different aspects of cardiovascular disease (hypertension, stroke, heart failure, ischemic heart disease and atherogenesis). Because of a close association between diabetes and heart disease, a discussion of the effects of particulate matter on diabetes is also included. Later chapters discuss the effects of individual pollutants such as vehicular emissions, metals and aldehydes. A review on manufactured nanoparticles is incorporated because these particles represent an important new threat to cardiovascular health. The understanding that emerges from this monograph suggests that we must be more alert to the effects of the environment and develop strategies that target, not only the diseased individual, but also the unhealthy, disease-causing environment. It is essential reading for cardiologists, epidemiologists, urban planners and pollution control specialists.