Protect your heart from environmental risk factors during American Heart Month
February may bring to mind hearts filled with love thanks to Valentine’s Day, but as American Heart Month, it also draws attention to a sobering reality: Cardiovascular diseases are the leading cause of death worldwide. While diet and exercise are top of mind when thinking about cardiovascular health, recent research shows that environmental factors such as air pollution and extreme heat also play an increasingly significant role in heart health.
That’s why various authors—including Sanjay Rajagopalan, MD, director of Case Western Reserve University School of Medicine’s Cardiovascular Research Institute—and three major organizations on heart health are calling for unprecedented action to address environmental risks to cardiovascular health on a global scale.
In “Environmental Stressors and Cardiovascular Health: Acting Locally for Global Impact in a Changing World”—published last month in Journal of the American College of Cardiology—the European Society of Cardiology, American College of Cardiology, American Heart Association and World Heart Federation call attention to environmental exposures as legitimate factors leading to cardiovascular disease. They further provide a scientific and policy-driven framework that governments, researchers, clinicians and even individuals can and should act upon.
In light of American Heart Month, we asked Rajagopalan how the world can work together to reduce environmental risks, as well as how we as individuals can protect our own hearts.
When talking about heart health, the focus is often on diet and exercise. Why should environmental factors also be part of the conversation?
For decades, cardiovascular prevention has centered on individual behaviors—diet, physical activity, smoking cessation. While these remain foundational, they tell only part of the story. A growing body of evidence shows that environmental exposures are powerful, independent drivers of cardiovascular risk.
These include air pollution, noise, extreme heat, chemical contaminants, light pollution and climate-related events such as wildfires or floods. Unlike lifestyle risks, these exposures are often involuntary and chronic.
Importantly, environmental stressors are ubiquitous and cumulative. Urbanization, industrialization and climate change have intensified exposure density, meaning that even individuals with optimal lifestyles may face substantial residual risk. Integrating environmental health into cardiovascular medicine expands prevention from the clinic to the community and policy sphere.
What policies, community changes and clinical practices would make the biggest difference for heart health?
The greatest gains will come from upstream interventions that reduce exposure at the population level.
From a policy standpoint, clean air regulations remain the single most impactful lever, targeting emissions from transportation, energy production and industry. Policies that reduce environmental noise, regulate chemical contaminants and address plastic and particulate pollution are also critical. Climate mitigation and adaptation strategies—heat action plans, wildfire preparedness and resilient infrastructure—are increasingly cardiovascular policies as much as environmental ones.
At the community level, urban design matters. Expanding green spaces, promoting active transport, reducing traffic density near residential zones and ensuring equitable zoning can simultaneously lower pollution, noise and heat exposure.
[In clinical settings,] environmental exposure history should become part of cardiovascular risk assessment. Health systems can incorporate air quality alerts, heat advisories and environmental risk counseling into routine care, particularly for high-risk patients. Professional societies and training programs also have a role in embedding planetary health into cardiovascular education.
How could this joint statement help move the needle when it comes to addressing environmental risk factors?
This statement is important because it represents a unified position across the world’s leading cardiovascular organizations.
First, it legitimizes environmental exposures as core cardiovascular risk factors rather than peripheral concerns. Second, it provides a scientific and policy framework that clinicians, researchers and governments can act upon. Third, it amplifies advocacy and helps translate epidemiology and mechanistic science into regulatory momentum.
By framing environmental stressors as modifiable drivers of global cardiovascular mortality and emphasizing that interventions require political will, international cooperation and systems-level change, the statement moves the conversation from awareness to accountability
What simple steps can individuals take to protect their hearts from environmental risks?
It is important to emphasize that personal mitigation has limits. Environmental cardiovascular risk is fundamentally a collective challenge—requiring structural, regulatory and societal solutions alongside individual action. While many environmental determinants require policy solutions, individuals can still take practical steps to reduce personal exposure:
- Monitor local air quality indices. Limit outdoor exertion on high-pollution days, especially if you are someone who is vulnerable to chronic cardiopulmonary conditions, aged, very young, or on immunosuppressive medications. Use high-efficiency indoor air filtration where feasible.
- Stay hydrated and avoid peak heat hours. Ensure cooling access during heat waves, particularly for those with cardiovascular disease.
- Reduce chronic exposure [to noise] where possible (home insulation, quiet sleep environments).
- Exercise in green spaces rather than high-traffic corridors when feasible.
- Reduce indoor pollutants (ventilation, minimizing combustion sources, cautious chemical use).
