A crossroads between the heart and lungs: air pollution and pulmonary hypertension. Issue 5 (30th May 2019) - McCormack, Meredith C.
While most studies of air pollution health effects have been in the general population, studying subgroups with chronic disease has the potential to define the magnitude of the health effects in sensitive populations and may provide unique insights into the mechanism of pollutant effects. Studies have shown indoor air pollution to be associated with increased chronic obstructive pulmonary disease (COPD) morbidity [1] and outdoor air pollution with increased COPD morbidity and mortality [2]. Recent work in idiopathic pulmonary fibrosis (IPF) has suggested that outdoor air pollution may be associated with steeper rate of lung function decline, risk of IPF exacerbation, and increase in mortality [3–5]. While these and other studies have investigated lung function, exacerbations and mortality, air pollution studies have not previously included assessment of pulmonary vascular effects, as this outcome is not easily accessible. Pulmonary arterial hypertension (PAH) cohorts often include catherisation data as part of longitudinal assessment of disease course and thus, studies in populations with pulmonary hypertension provide a unique opportunity to link air pollution exposure to physiological effects on the pulmonary circulation. Proximity to traffic and particulate pollution may be associated with disease severity and increased mortality in individuals with pulmonary arterial hypertension. Future studies are needed to confirm these findings. http://bit.ly/2P5QE52