Cardiovascular effects of air pollution: current evidence from animal and human studies

Am J Physiol Heart Circ Physiol. 2021 Apr 1;320(4):H1417-H1439. doi: 10.1152/ajpheart.00706.2020. Epub 2021 Jan 29.


Air pollution is a global health concern. Particulate matter (PM)2.5, a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM2.5, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.

Keywords: PM2.5; blood pressure; cardiovascular; endothelium; pollution.

Publication types

  • Systematic Review

MeSH terms

  • Air Pollutants / adverse effects*
  • Air Pollution / adverse effects*
  • Animals
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / drug effects*
  • Cardiovascular System / metabolism
  • Cardiovascular System / physiopathology
  • Environmental Monitoring
  • Hemodynamics / drug effects
  • Humans
  • Inhalation Exposure / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Signal Transduction


  • Air Pollutants