Gene–Air Pollution Interaction in Cardiovascular Disease: Lights and Shadows in a Tangled Risk Factor Network

Cardiovascular disease (CVD) is the result of a complex interaction between genetic, lifestyle, and environmental factors, which may vary over the course of life. Traditional risk factors do not explain all patients' risks; thus, the research of additional biomarkers to refine cardiovascular risk prediction has attracted considerable interest in recent years. Genetic factors, as well as air pollution exposure, among nontraditional factors, have been found to be critical determinants of CV risk. Accordingly, this narrative review aims to provide a comprehensive summary of the literature (PubMed) on the combined effects of air pollution and genetic susceptibility on CVD risk. Although different limitations and pitfalls are still to be solved, available evidence suggests that genetic variants (especially genes related to detoxification and inflammation) are involved in the association between air pollution exposure and CV adverse events. Thus, this research area could provide further knowledge of the etiology of CVD, offering new tools for targeted prevention and treatment of more susceptible subjects from a more personalized medicine point of view.