Specific environmental exposures can help pre

image: Spatial models for six spatial environmental factors in Golestan province, Iran. These models were used to assign environmental exposures to individuals based on their place of residence.
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A new study from the Icahn School of Medicine at Mount Sinai quantifies the cardiovascular risk posed by exposure to specific environmental factors, showing, for example, that air pollution increases the risk of death from heart disease by 17% .

The research, published June 24 in PLOS ONE, is the first to examine the impact of multiple environmental risk factors on cardiovascular mortality and may lead to increased patient screening and preventative measures to improve chances of survival.

According to the Institute for Health Metrics and Evaluation, an independent population health research organization based at the University of Washington School of Medicine, environmental hazards were responsible for an estimated 11.3 million deaths in 2019. , of which 5.1 million were due to cardiovascular disease.

“This study advances our understanding of the environmental factors that may be most detrimental to cardiovascular health,” says first author Michael Hadley, MD, cardiology fellow and new assistant professor of medicine (cardiology) at the Icahn School of Medicine in Mount Sinai. “By combining many environmental factors in a single model, we could better control for risk factor interactions and identify the most important environmental risk factors for cardiovascular health.”

The study, known as the Golestan Cohort Study, took place in Iran between 2004 and 2008. Participants came from Golestan province, a low-income, multi-ethnic and predominantly rural region where cardiovascular disease are the leading cause of death.

Researchers from Mount Sinai Health System and NYU Grossman School of Medicine conducted this international multicenter study. They analyzed data from more than 50,000 participants, all over the age of 40, who completed a detailed lifestyle questionnaire and physical exam. Within this group, there were more than 2,700 cardiovascular deaths and nearly 6,000 deaths from all causes during a 10-year follow-up period.

Investigators used environmental data from the National Aeronautics and Space Administration along with geographic information systems technology to create maps of eight environmental risk factors across Gulistan: air pollution from ambient fine particles; how households cooked, heated and ventilated their homes; how far they lived from traffic; proximity to hospitals performing percutaneous coronary intervention; neighborhood socio-economy; population density; the type of terrain they live on; and whether their location is bright at night. They assigned exposures to participants based on where they lived on these risk maps and performed statistical analysis to identify associations between death and environmental risk factors, while controlling for traditional risk factors such as as obesity, physical inactivity, diabetes, smoking and hypertension. .

They found that people exposed to the highest levels of outdoor air pollution were 17% more likely to die of heart disease than those not exposed, and 20% more likely to experience all-cause mortality. Participants exposed to indoor combustion of wood, manure, or other biomaterials without ventilation were 36% more likely to die of heart disease and 23% more likely to experience all-cause mortality. People exposed to indoor kerosene combustion without ventilation were 19% more likely to die of heart disease and 9% more likely to die of all-cause mortality. For every 10 km that participants lived away from a catheterization laboratory, the risk of cardiovascular death increased by 2% and all-cause mortality by 1%; the researchers estimated that most people in this area lived more than 80 km from these clinics. Living about 0.06 miles from a minor road and 0.25 miles from a major highway was associated with a 13% increased risk of all-cause mortality. Socioeconomic status, population density, night light, and soil were not associated with an increased risk of death; most other results showed borderline statistical significance.

The researchers also calculated that the burden of heart disease attributed to indoor and outdoor pollution was equivalent to the burden of cardiovascular disease from smoking.

“Our work shows how publicly available data can be used to create risk maps for individual communities, even in low-income rural settings. Ultimately, we expect health systems to use similar approaches to create environmental risk maps for the communities they serve. The data can allow physicians to estimate environmental risks to their patients and offer personalized recommendations to mitigate risk,” says Dr. Hadley.

Lead author Rajesh Vedanthan, MD, MPH, associate professor in the Department of Population Health and Department of Medicine at NYU Langone Health, adds, “For example, a cardiologist in California could screen his patients for risk of exposure to forest fire smoke. Doctors could then recommend key interventions for at-risk patients, such as monitoring local air pollution levels and staying indoors, wearing a mask or using air filtration. indoor air to reduce exposures when pollution levels are high. Our findings help broaden the disease risk profile beyond age and traditional personal risk factors.

The National Heart, Lung and Blood Institutewhich is part of the National Institutes of Health, helped fund this study.

About Mount Sinai Health System

The Mount Sinai Health System is one of the largest academic medical systems in the New York metropolitan area, with more than 43,000 employees working in eight hospitals, more than 400 outpatient practices, nearly 300 laboratories, a nursing school and a leading medical and medical school. Higher Education. Mount Sinai advances health for everyone, everywhere, by addressing the most complex health challenges of our time – discovering and applying new knowledge and scientific knowledge; developing safer and more effective treatments; train the next generation of medical leaders and innovators; and supporting local communities by providing high quality care to all who need it.

Through the integration of its hospitals, laboratories and schools, Mount Sinai offers comprehensive healthcare solutions from birth to geriatrics, leveraging innovative approaches such as artificial intelligence and IT while keeping patients’ medical and emotional needs at the center of all treatments. The health system includes approximately 7,300 primary and specialty care physicians; 13 joint venture day surgery centers in the five boroughs of New York, Westchester, Long Island and Florida; and over 30 affiliated community health centers. We are consistently ranked by US News & World Report’s Top Hospitals, receiving a high “Honor Roll” status, and are highly ranked: #1 in Geriatrics and Top 20 in Cardiology/Cardiac Surgery, Diabetes/Endocrinology, Gastroenterology /gastrointestinal surgery, neurology /Neurosurgery, orthopaedics, pulmonology/pulmonary surgery, rehabilitation and urology. New York Eye and Ear Infirmary of Mount Sinai is ranked #12 in ophthalmology. US News & World Report’s “Best Hospitals for Children” ranks Mount Sinai Kravis Children’s Hospital among the nation’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that has stood out on several metrics: it is consistently ranked in the top 20 by US News & World Report’s “Best Medical Schools”, aligned with a U.S. News & World Report Hospital “Honor Roll”, and among the top 20 nationwide for National Institutes of Health funding and among the top 5 nationwide for many areas of basic and clinical research. Newsweek’s “World’s Best Smart Hospitals” ranks Mount Sinai Hospital number one in New York and among the top five in the world, and Mount Sinai Morningside in the top 20 globally.

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