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J. Clin. Med. 2019, 8(2), 274;

A Systematic Review of the Short-Term Health Effects of Air Pollution in Persons Living with Coronary Heart Disease

Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Department of Heart Wise Exercise, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
Author to whom correspondence should be addressed.
Received: 30 January 2019 / Revised: 13 February 2019 / Accepted: 21 February 2019 / Published: 24 February 2019
(This article belongs to the Special Issue Cardiac Rehabilitation)
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Persons living with chronic medical conditions (such as coronary artery disease (CAD)) are thought to be at increased risk when exposed to air pollution. This systematic review critically evaluated the short-term health effects of air pollution in persons living with CAD. Original research articles were retrieved systematically through searching electronic databases (e.g., Medical Literature Analysis and Retrieval System Online (MEDLINE)), cross-referencing, and the authors’ knowledge. From 2884 individual citations, 26 eligible articles were identified. The majority of the investigations (18 of 22 (82%)) revealed a negative relationship between air pollutants and cardiac function or overall health. Heart rate variability (HRV) was the primary cardiovascular outcome measure, with 10 out of 13 studies reporting at least one index of HRV being significantly affected by air pollutants. However, there was some inconsistency in the relationship between HRV and air pollutants, mediated (at least in part) by the confounding effects of beta-blocker medications. In conclusion, there is strong evidence that air pollution can have adverse effects on cardiovascular function in persons living with CAD. All persons living with CAD should be educated on how to monitor air quality, should recognize the potential risks of excessive exposure to air pollution, and be aware of strategies to mitigate these risks. Persons living with CAD should minimize their exposure to air pollution by limiting outdoor physical activity participation when the forecast air quality health index indicates increased air pollution (i.e., an increased risk). View Full-Text
Keywords: exercise; air quality health index; coronary artery disease exercise; air quality health index; coronary artery disease

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Warburton, D.E.R.; Bredin, S.S.D.; Shellington, E.M.; Cole, C.; de Faye, A.; Harris, J.; Kim, D.D.; Abelsohn, A. A Systematic Review of the Short-Term Health Effects of Air Pollution in Persons Living with Coronary Heart Disease. J. Clin. Med. 2019, 8, 274.

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