Climate change, air pollution and arterial hypertension: prevention strategies
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Abstract
The aim of this literature review is to assess the role of climatic factors on blood pressure and the course of arterial hypertension, and to analyze ways to reduce the negative environmental impact on patients. This article focuses on analyzing scientific data linking climate change, particularly extreme temperatures, air pollution, and changing weather conditions, to an increased risk of arterial hypertension and its complications. The article examines the main mechanisms of this impact and proposes practical prevention and adaptation strategies to minimize the negative effects of climate and the environment on blood pressure and the cardiovascular system as a whole.
Conclusions. A comprehensive approach to preventing the negative consequences of climate change should include a patient-centered strategy for blood pressure control, a healthy lifestyle, avoiding extreme temperatures, and individual adaptation and protection methods. The implementation of WHO recommendations at the state level regarding air quality monitoring and maintenance is a key factor in preventing arterial hypertension and the development of its complications under the influence of negative climatic factors.
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References
McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, Christodorescu RM, Daskalopoulou SS, Ferro CJ, Gerdts E, Hanssen H, Harris J, Lauder L, McManus RJ, Molloy GJ, Rahimi K, Regitz-Zagrosek V, Rossi GP, Sandset EC, Scheenaerts B, Staessen JA, Uchmanowicz I, Volterrani M, Touyz RM; ESC Scientific Document Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024 Oct 7;45(38):3912-4018. doi: 10.1093/eurheartj/ehae178. Erratum in: Eur Heart J. 2025 Apr 7;46(14):1300. https://doi.org/10.1093/eurheartj/ehaf031
Yoneyama K, Nakai M, Higuma T, et al. Weather temperature and the incidence of hospitalization for cardiovascular diseases in an aging society. Sci Rep. 2021;11:10863. https://doi.org/10.1038/s41598-021-90352-x
Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet. 2021 Aug 21;398(10301):698-708. https://doi.org/10.1016/S0140-6736(21)01208-3
Liu J, Varghese BM, Hansen A, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Heat exposure and cardiovascular health outcomes: a systematic review and meta-analysis. Lancet Planet Health. 2022 Jun;6(6):e484-e495. https://doi.org/10.1016/S2542-5196(22)00117-6
Wang Q, Li C, Guo Y, Barnett AG, Tong S, Phung D, Chu C, Dear K, Wang X, Huang C. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis. Sci Total Environ. 2017 Jan 1;575:276-286. https://doi.org/10.1016/j.scitotenv.2016.10.019
Brook RD. The Environment and Blood Pressure. Cardiol Clin. 2017 May;35(2):213-221. https://doi.org/10.1016/j.ccl.2016.12.003
Meade RD, Akerman AP, Notley SR, McGarr GW, McCourt ER, Kirby NV, Costello JT, Cotter JD, Crandall CG, Zanobetti A, Kenny GP. Meta-analysis of heat-induced changes in cardiac function from over 400 laboratory-based heat exposure studies. Nat Commun. 2025 Mar 14;16(1):2543. https://doi.org/10.1038/s41467-025-57868-6
Lanzinger S, Hampel R, Breitner S, Rückerl R, Kraus U, Cyrys J, Geruschkat U, Peters A, Schneider A. Short-term effects of air temperature on blood pressure and pulse pressure in potentially susceptible individuals. Int J Hyg Environ Health. 2014 Sep;217(7):775-84. https://doi.org/10.1016/j.ijheh.2014.04.002
Narita K, Hoshide S, Kario K. Seasonal variation in blood pressure: current evidence and recommendations for hypertension management. Hypertens Res. 2021 Nov;44(11):1363-1372. https://doi.org/10.1038/s41440-021-00732-z
Kamiński M, Cieślik-Guerra UI, Kotas R, Mazur P, Marańda W, Piotrowicz M, Sakowicz B, Napieralski A, Trzos E, Uznańska-Loch B, Rechciński T, Kurpesa M. Evaluation of the impact of atmospheric pressure in different seasons on blood pressure in patients with arterial hypertension. Int J Occup Med Environ Health. 2016;29(5):783-92. https://doi.org/10.13075/ijomeh.1896.00546
Charach L, Grosskopf I, Karniel E, Charach G. A Meteorological Paradox: Low Atmospheric Pressure-Associated Decrease in Blood Pressure Is Accompanied by More Cardiac and Cerebrovascular Complications: Five-Year Follow-Up of Elderly Hypertensive Patients. Atmosphere. 2022;13:235. https://doi.org/10.3390/atmos13020235
Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, et al. ESC Scientific Document Group, 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 7 Sep 2021;42(34):3227-3337. https://doi.org/10.1093/eurheartj/ehab484
GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2100-2132. https://doi.org/10.1016/S0140-6736(24)00367-2
Rajagopalan S, Brauer M, Bhatnagar A, Bhatt DL, Brook JR, Huang W, Münzel T et al.; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Personal-Level Protective Actions Against Particulate Matter Air Pollution Exposure: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 8;142(23):e411-e431. https://doi.org/10.1161/CIR.0000000000000931
Hu J, Xue X, Xiao M, Wang W, Gao Y, Kan H, Ge J, et al. The acute effects of particulate matter air pollution on ambulatory blood pressure: A multicenter analysis at the hourly level. Environ Int. 2021 Dec;157:106859. https://doi.org/10.1016/j.envint.2021.106859
Zhu A, Liu M, Yu J, Zhang R, Zhang Y, Chen R, Ruan Y. Association between air pollution and hypertension hospitalizations: a time series analysis in Lanzhou. BMC Public Health. 2024 Nov 23;24(1):3260. https://doi.org/10.1186/s12889-024-20740-1
Rajagopalan S, Landrigan PJ. Pollution and the Heart. N Engl J Med. 2021 Nov 11;385(20):1881-1892. https://doi.org/10.1056/NEJMra2030281
Li X, Zhang W, Laden F, Curhan GC, Rimm EB, Guo X, Hart JE, Wu S. Dietary nitrate intake and vegetable consumption, ambient particulate matter, and risk of hypertension in the Nurses’ Health study. Environ Int. 2022 Mar;161:107100. https://doi.org/10.1016/j.envint.2022.107100
Arku RE, Brauer M, Ahmed SH, AlHabib KF, Avezum Á, Bo J, Choudhury T et al. Long-term exposure to outdoor and household air pollution and blood pressure in the Prospective Urban and Rural Epidemiological (PURE) study. Environ Pollut. 2020 Jul;262:114197. https://doi.org/10.1016/j.envpol.2020.114197
Zhang J, Zhang F, Xin C, Duan Z, Wei J, Zhang X, Han S, Niu Z. Associations of long-term exposure to air pollution, physical activity with blood pressure and prevalence of hypertension: the China Health and Retirement Longitudinal Study. Front Public Health. 2023 May 3;11:1137118. https://doi.org/10.3389/fpubh.2023.1137118
Niu Z, Duan Z, Yu H, Xue L, Liu F, Yu D, Zhang K, et al. Association between long-term exposure to ambient particulate matter and blood pressure, hypertension: an updated systematic review and meta-analysis. Int J Environ Health Res. 2023 Mar;33(3):268-283. https://doi.org/10.1080/09603123.2021.2022106
Hahad O, Rajagopalan S, Lelieveld J, Sørensen M, Kuntic M, Daiber A, Basner M, et al. Noise and Air Pollution as Risk Factors for Hypertension: Part II-Pathophysiologic Insight. Hypertension. 2023 Jul;80(7):1384-1392. https://doi.org/10.1161/HYPERTENSIONAHA.123.20617
Hahad O, Wojciechowska W, Kuntic M, Pozzer A, Grassos C, Rajzer M. Air pollution and hypertension: Mechanistic and epidemiological insights. Kardiol Pol. 2025;83(5):546-555. https://doi.org/10.33963/v.phj.105320
Salimi S, Yanosky JD, Huang D, et al. Long-term exposure to particulate air pollution and brachial artery flow-mediated dilation in the Old Order Amish. Environ Health. 2020;19(1):50. https://doi.org/10.1186/s12940-020-00593-y
Kuntic M, Kuntic I, Krishnankutty R, et al. Co-exposure to urban particulate matter and aircraft noise adversely impacts the cerebro-pulmonary-cardiovascular axis in mice. Redox Biol. 2023;59:102580, https://doi.org/10.1016/j.redox.2022.102580
Wang H, Wang T, Rui W, et al. Extracellular vesicles enclosed-miR-421 suppresses airpollution (PM)-induced cardiac dysfunction via ACE2 signalling. J Extracell Vesicles. 2022;11(5):e12222. https://doi.org/10.1002/jev2.12222
Liang Y, Chu PH, Tian L, Ho KF, Ip MSM, Mak JCW. Targeting mitochondrial permeability transition pore ameliorates PM2.5-induced mitochondrial dysfunction in airway epithelial cells. Environ Pollut. 2022 Feb 15;295:118720. https://doi.org/10.1016/j.envpol.2021.118720
Tsai DH, Riediker M, Wuerzner G, Maillard M, Marques-Vidal P, Paccaud F, Vollenweider P et al. Short-term increase in particulate matter blunts nocturnal blood pressure dipping and daytime urinary sodium excretion. Hypertension. 2012 Oct;60(4):1061-9. https://doi.org/10.1161/HYPERTENSIONAHA.112.195370
Laumbach R, Meng Q, Kipen H. What can individuals do to reduce personal health risks from air pollution? J Thorac Dis. 2015;7(1):96-107, https://doi.org/10.3978/j.issn.2072-1439.2014.12.21
Rocha-Velasco OA, Morales-Suárez-Varela M, Llopis-González A. Dietary Flavonoids: Mitigating Air Pollution’s Cardiovascular Risks. Nutrients. 2024;16(16):2647. https://doi.org/10.3390/nu16162647
WHO Global Air Quality Guidelines: Particulate Matter (PM2.5 and PM10), Ozone, Nitrogen Dioxide, Sulphur Dioxide and Carbon Monoxide. WHO. Retrieved 1 June 2025. Available at: https://www.who.int/publications/i/item/9789240034228
Miller MR, Di Cesare M, Rahimzadeh S, Adeoye M, Perel P, Taylor S, Shrikhande S, et al. Clearing the Air to Address Pollution’s Cardiovascular Health Crisis. Global Heart. 2024;19(1):82. https://doi.org/10.5334/gh.1364
Zero Pollution Action Plan Towards zero pollution for air, water and soil: European Commission. https://environment.ec.europa.eu/strategy/zero-pollution-actionplan_en (accessed: June 2, 2025)
Nieuwenhuijsen MJ. Urban and transport planning pathways to carbon neutral, liveable and healthy cities; A review of the current evidence. Environ Int. 2020 Jul;140:105661. https://doi.org/10.1016/j.envint.2020.105661
Diener A, Mudu P. How can vegetation protect us from air pollution? A critical review on green spaces’ mitigation abilities for air-borne particles from a public health perspective – with implications for urban planning. Sci Total Environ. 2021 Nov 20;796:148605. https://doi.org/10.1016/j.scitotenv.2021.148605
Aram F, Higueras García E, Solgi E, Mansournia S. Urban green space cooling effect in cities. Heliyon. 2019 Apr 8;5(4):e01339. https://doi.org/10.1016/j.heliyon.2019.e01339
Gostimirovic M, Novakovic R, Rajkovic J, Djokic V, Terzic D, Putnik S, Gojkovic-Bukarica L. The influence of climate change on human cardiovascular function. Arch Environ Occup Health. 2020;75(7):406-414. https://doi.org/10.1080/19338244.2020.1742079
Stergiou GS, Kyriakoulis KG, Kollias A, McManus RJ, Menti A, Parati G, Schutte AE, Wang J, Asayama K, Asmar R, Bilo G, Chapman N, Fujiwara T, Head G, Kahn N, Kario K, Li Y, Manios E, Mariglis D, Mihailidou AS, Muntner P, Myers M, Niiranen T, Ohkubo T, Omboni S, Protogerou A, Saladini F, Sharman J, Shimbo D, De La Sierra A, Palatini P. Blood pressure measurement at kiosks in public spaces: systematic review and consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability endorsed by the International Society of Hypertension and the World Hypertension League. J Hypertens. 2025 Apr 1;43(4):577-588. https://doi.org/10.1097/HJH.0000000000003965
