Aerogenic pollutants as risk factors causing development of cardio-metabolic pathology (review)

Ambient air pollution causes approximately 3.3 million untimely deaths annually (2.1 deaths due to ischemic heart disease and 1.1 million deaths due to stroke). Mortality caused by ambient air pollution is higher than mortality due to such traditional risk factors as smoking, obesity, and elevated dextrose contents in blood. Relative risk of mortality amounts to 1.26 (95 % CI 1.08-1.47) in cities with the highest air pollution against those where air pollution is the lowest. Occupational exposure to various chemical air pollutants can cause more than 1 million untimely deaths all over the world but its contribution to prevalence of cardiovascular diseases has not been determined sufficiently. Aerogenic pollutants are quite variable in their chemical structure and include both particulate matter (PM for short) and gaseous matter. The American Heart Association and the European Society of Cardiology consider PM2.5 to be a risk factor causing cardiovascular diseases. This analytical review presents data on effects produced by aerogenic pollutants on development of cardio-metabolic pathology and population mortality due to vascular and metabolic diseases (arterial hypertension, atherosclerosis and ischemic heart disease, heart rhythm disturbances, and type 2 diabetes mellitus). There are also data on mechanisms of pathogenetic influence exerted by aerogenic pollutants on development of such diseases including generation of anti-inflammatory and oxidative mediators and their release into blood flow; developing imbalance in the autonomic nervous system with prevailing activity of the sympathetic nervous system and disrupted heart rate variability; direct introduction of aerogenic pollutants from the lungs into blood flow with developing direct toxic effects. We have also analyzed literature data on protective effects produced by reduction in ambient air pollution on prevalence of cardiovascular pathology.