Environmental Stressors and Cardiovascular Health: Acting Locally for Global Impact in a Changing World: A Statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation

Jan 20, 2026Circulation

How Environmental Stressors Affect Heart and Blood Vessel Health Worldwide

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Abstract

Non-communicable diseases (NCDs) account for 70% of global mortality, with cardiovascular disease (CVD) making up a significant portion of these deaths.

There is increasing evidence that environmental risk factors (ERFs) contribute to the rising prevalence of NCDs.
ERFs include air pollution, noise exposure, artificial light at night, plastic pollution, chemical pollution, and climate change-related events.
Urbanization has intensified exposure to many ERFs, creating environments that may worsen public health outcomes.
Regulatory and policy-driven interventions are necessary to address the sources of these exposures and minimize health impacts, particularly for vulnerable populations.
Integrating planetary and environmental health into cardiovascular care may help reduce the incidence of CVDs.

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Non-communicable diseases (NCDs) account for 70% of global mortality and are responsible for over 38 million deaths annually, with cardiovascular disease (CVD) constituting most of these fatalities. While traditional risk factors for CVD have long been recognized, there is growing evidence that a rising prevalence of ubiquitous environmental risk factors (ERFs) may play an increasingly significant role in the genesis and rising prevalence of NCDs. ERFs include many interconnected anthropogenic exposures with cumulative compound health impacts, including air pollution, noise exposure, artificial light at night, plastic pollution, chemical pollution and the various effects of climate change, such as heat extremes, desert storms, floods and wildfires. Urbanization has intensified the impact of many ERFs and created intense exposure environments, highlighting the urgency and the opportunity to address these for maximum public health benefit. Impactful intervention often requires regulatory and policy-driven efforts addressing the genesis of exposures and minimizes their health impact, particularly in vulnerable populations who may contribute the least but may be impacted the most. Solutions must involve the development of resiliency and adaptation measures to a changing world, where the probability of sudden catastrophic and cascading events is much more likely. Political will and international cooperation are essential in establishing and enforcing regulations that promote cleaner air and water, quieter and natural biodiverse environments, and sustainable infrastructure in urban, and rural medical facilities. Integration of planetary and environmental health into cardiovascular care will be vital in reducing the burden of NCDs globally. By addressing the root causes of environmental stressors, it is possible to reduce the incidence of CVDs and promote healthier, just and sustainable societies.

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Environmental Stressors and Cardiovascular Health: Acting Locally for Global Impact in a Changing World: A Statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation

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