Non-communicable diseases (NCDs) account for 70% of global mortality, claiming over 38 million lives each year, with cardiovascular disease (CVD) as the leading contributor. While conventional risk factors like smoking, hypertension, and poor diet remain critical, emerging evidence highlights the escalating role of ubiquitous environmental risk factors (ERFs) in driving the rise of NCDs, particularly CVD. These interconnected anthropogenic exposures—air pollution, noise and light pollution, chemical and plastic contamination, water and soil pollution, and climate-related hazards—exert cumulative and compounding effects on cardiovascular health. They operate through shared pathophysiological mechanisms, including oxidative stress, systemic inflammation, autonomic nervous system imbalance, and endothelial dysfunction, amplifying overall risk beyond traditional factors.
Environmental stressors are estimated to account for 4–6 million of the approximately 20 million annual CVD deaths worldwide, equating to roughly one in five CVD fatalities—surpassing the impact of several well-established risk factors. The interplay among these exposures underscores the need for an exposome-based approach to prevention, recognizing their synergistic and often inequitable burden on vulnerable populations.
This joint statement, issued by the European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA), and World Heart Federation (WHF), represents the first unified call from leading global cardiovascular organizations for urgent, coordinated action. It emphasizes that environmental protection must become central to CVD prevention strategies and policy frameworks. Key priorities include advocating for stricter air quality and noise regulations, accelerating the phase-out of fossil fuels, enforcing controls on toxic chemicals, and fostering international cooperation to harmonize standards and build political will.
By addressing root causes locally—through community-level interventions, urban planning, and policy advocacy—meaningful global impact is achievable, reducing CVD incidence while advancing healthier, more equitable, and sustainable societies in a changing world. The statement calls on policymakers, healthcare professionals, and communities to prioritize these preventable environmental threats as a core component of cardiovascular health protection.
Link: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf915/8429001?login=false
