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Review
. 2022 Dec;75(12):1050-1058.
doi: 10.1016/j.rec.2022.05.030. Epub 2022 Aug 2.

Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment

[Article in English, Spanish]
Jordi Bañeras  1 , Josep Iglesies-Grau  2 , María Téllez-Plaza  3 , Vicente Arrarte  4 , Néstor Báez-Ferrer  5 , Begoña Benito  1 , Raquel Campuzano Ruiz  6 , Alberto Cecconi  7 , Alberto Domínguez-Rodríguez  8 , Antonio Rodríguez-Sinovas  1 , Francisco Ujueta  9 , Carlos Vozzi  10 , Gervasio A Lamas  11 , Ana Navas-Acién  12
Affiliations
Review

Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment

[Article in English, Spanish]
Jordi Bañeras et al. Rev Esp Cardiol (Engl Ed). 2022 Dec.

Abstract

The environment is a strong determinant of cardiovascular health. Environmental cardiology studies the contribution of environmental exposures with the aim of minimizing the harmful influences of pollution and promoting cardiovascular health through specific preventive or therapeutic strategies. The present review focuses on particulate matter and metals, which are the pollutants with the strongest level of scientific evidence, and includes possible interventions. Legislation, mitigation and control of pollutants in air, water and food, as well as environmental policies for heart-healthy spaces, are key measures for cardiovascular health. Individual strategies include the chelation of divalent metals such as lead and cadmium, metals that can only be removed from the body via chelation. The TACT (Trial to Assess Chelation Therapy, NCT00044213) clinical trial demonstrated cardiovascular benefit in patients with a previous myocardial infarction, especially in those with diabetes. Currently, the TACT2 trial (NCT02733185) is replicating the TACT results in people with diabetes. Data from the United States and Argentina have also shown the potential usefulness of chelation in severe peripheral arterial disease. More research and action in environmental cardiology could substantially help to improve the prevention and treatment of cardiovascular disease.

Keywords: Air pollution; Cardiología ambiental; Contaminación atmosférica; Environment; Environmental cardiology; Material particulado; Medioambiente; Metales; Metals; Particulate matter.

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Conflict of interest statement

CONFLICTO DE INTERESES

Ningún autor tiene conflicto de intereses con el presente trabajo.

Figures

Figura 1.
Figura 1.
Figura central. Definición y relevancia de la cardiología ambiental.
Figura 2.
Figura 2.
Estrategias ambientales para la salud cardiovascular.
Figura 3.
Figura 3.
Fotos de pacientes con enfermedad arterial periférica grave al inicio y tras infusiones repetidas con el agente quelante EDTA (etilendiaminotetraacetato) disódico de un paciente de Miami, Estados Unidos (A, reproducido con permiso de Arenas et al.) y Rosario, Argentina (B, reproducido con permiso de Ujueta et al.).
See this image and copyright information in PMC

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