From inflammation to blood clots: Understanding how air pollution can raise heart attack risk and what happens inside blood vessels

Air pollution is more than a lung concern. Here’s how poor air quality can affect your heart and blood vessels.

A sudden rise in air pollution does more than irritate the lungs; it can also place considerable stress on the heart and blood vessels. Exposure to high concentrations of particulate matter, particularly PM2.5, can trigger a series of inflammatory and vascular responses that may increase the risk of a heart attack, especially in people with existing cardiovascular conditions. In an interview with HT Lifestyle, Dr Anshul Kumar Jain, director of Cardiology at the CK Birla Hospital, Delhi, shared the impact of air pollution on the heart.

Can rising air pollution increase your risk of a heart attack?

According to Dr Jain, when polluted air is inhaled, fine particulate matter can travel deep into the lungs and, in some cases, enter the bloodstream. These particles trigger oxidative stress and inflammation, which can affect the inner lining of blood vessels, known as the endothelium. The endothelium plays an important role in regulating blood flow and maintaining vascular health. When its functioning is impaired, blood vessels may become less flexible, and their ability to dilate can be reduced.

When polluted air is inhaled, fine particulate matter can travel deep into the lungs and, in some cases, enter the bloodstream. (Pexel)

How does air pollution impact the cardiovascular system?

“Air pollution can also activate the sympathetic nervous system, responsible for the body's stress response,” said Dr Jain. This can lead to an increase in heart rate, blood pressure, and the workload on the heart. At the same time, inflammation can make existing atherosclerotic plaques, which are fatty deposits inside artery walls, more vulnerable to rupture. If a plaque ruptures, the body may form a blood clot at the site. This clot can partially or completely block blood flow to the heart muscle, resulting in a heart attack.

Another important concern is that particulate pollution can increase platelet activation and blood clotting tendencies. This makes the blood more prone to clot formation, further raising cardiovascular risks. The combination of increased blood pressure, vascular inflammation, reduced blood vessel function, and a greater tendency for clotting can create conditions that trigger an acute cardiac event.

Who is at risk?

The risk is particularly concerning for older adults and individuals with hypertension, diabetes, high cholesterol, coronary artery disease, or a previous history of heart attack. However, even people without a diagnosed heart condition may experience short-term cardiovascular stress during periods of severe pollution.

Symptoms such as chest discomfort, unusual breathlessness, cold sweating, dizziness, or pain radiating to the arm, jaw, or back should never be ignored. These could indicate a cardiac emergency and require immediate medical attention.

The risk is particularly concerning for older adults and individuals with hypertension, diabetes, high cholesterol, or coronary artery disease. (Pexel)

While avoiding outdoor exercise during peak pollution hours, using a well-fitted N95 mask and keeping indoor air clean can help reduce exposure. However, preventive measures should go hand in hand with regular monitoring of blood pressure, cholesterol, and blood sugar, particularly among high-risk individuals.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.