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Environmental Factors & Heart Disease.

Cardiovascular Disease (CVD), which includes heart disease and stroke, is the leading cause of death worldwide. Recent data suggest that individuals might be at a higher risk of CVD is higher in neighborhoods with greater social and environmental problems. 

A recent study found that a higher rate of pollution and unemployment led to widening disparities in cardiovascular health, and that a significant role was played by environmental factors. The environmental disadvantages included air and water pollution, the presence of toxic sites and hazardous materials, heavy road traffic, few recreational parks, along with the presence of airports and railways. Social factors included ethnic minority status, income, housing status and access to the internet and health care, in addition to education and employment levels. 

Residents of the most environmentally and socially vulnerable neighborhoods had about 1.7 times the rate of coronary heart disease, and more than twice the stroke rate compared to people from the least vulnerable neighborhoods. In addition, people in the most vulnerable areas have higher rates of chronic kidney disease, type 2 diabetes, obesity and higher blood pressure. Individuals living in the most  environmentally and socially vulnerable neighborhoods had the highest percentage of Black and Hispanic adults, while the least vulnerable neighborhoods had the lowest percentage of racial and ethnic minorities.

Reversing the impact of environmental and socioeconomic disadvantages requires multiple approaches that would reduce exposure to air pollution, addressing poverty and to reduce it, improving public education, job creation, urban revitalization , creating affordable housing and increasing access to quality health care. 

Environmental factors are not usually discussed with patients when we see them in our medical office. This recent study suggests that cardiovascular specialists should consider including the evaluation of these factors during the clinic consultation, and discuss with their patients how to reduce these factors. Patients should be made aware of the risks of environmental factors on their cardiovascular health, and how to reduce these factors, and this should be part of the health plan.

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