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Luftverschmutzung, Lärm und Hypertonie

Komplizen im Verbrechen

Air pollution, noise and hypertension

Partners in crime

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Zusammenfassung

Luftverschmutzung und Verkehrslärm sind wichtige Umweltrisikofaktoren, die die Gesundheit in städtischen Gesellschaften gefährden und oft gemeinsam als „Komplizen“ auftreten. Obwohl Luftverschmutzung und Lärm in städtischen Umgebungen häufig gleichzeitig auftreten, wurden sie in der Regel getrennt untersucht, wobei zahlreiche Studien konsistente Auswirkungen individueller Expositionen auf den Blutdruck dokumentieren. Im folgenden Übersichtsartikel beleuchten wir die Epidemiologie von Luftverschmutzung und Lärm mit Hinblick auf den Herz-Kreislauf-Risikofaktor arterielle Hypertonie sowie die zugrunde liegende Pathophysiologie. Beide Umweltbelastungen führen nachweislich zu einer endothelialen Dysfunktion, oxidativem Stress, einer ausgeprägten Gefäßentzündung, zur Störung des zirkadianen Rhythmus und zur Aktivierung des autonomen Nervensystems, die insgesamt die Entwicklung von Bluthochdruck und Herz-Kreislauf-Erkrankungen begünstigen. Aus gesellschaftlicher und politischer Sicht besteht dringender Bedarf, auf das Gefahrenpotenzial von Luftverschmutzung und Verkehrslärm in den Präventionsrichtlinien der American Heart Association (AHA)/des American College of Cardiology (ACC) und in den ESC(European Society of Cardiology)-Richtlinien zur Prävention hinzuweisen. Daher ist es ein wichtiges Ziel für die Zukunft, das Bewusstsein für Umweltrisikofaktoren als bedeutende und insbesondere vermeidbare Risikofaktoren für Herz-Kreislauf-Erkrankungen zu schärfen.

Abstract

Air pollution and traffic noise are two important environmental risk factors that endanger health in urban societies and often act together as “partners in crime”. Although air pollution and noise often co-occur in urban environments, they have typically been studied separately, with numerous studies documenting consistent effects of individual exposure on blood pressure. In the following review article, we examine the epidemiology of air pollution and noise, especially regarding the cardiovascular risk factor arterial hypertension and the underlying pathophysiology. Both environmental stressors have been shown to lead to endothelial dysfunction, oxidative stress, pronounced vascular inflammation, disruption of circadian rhythms and activation of the autonomic nervous system, all of which promote the development of hypertension and cardiovascular diseases. From a societal and political perspective, there is an urgent need to point out the potential dangers of air pollution and traffic noise in the American Heart Association (AHA)/American College of Cardiology (ACC) prevention guidelines and the European Society of Cardiology (ESC) guidelines on prevention. Therefore, an essential goal for the future is to raise awareness of environmental risk factors as important and, in particular, preventable risk factors for cardiovascular diseases.

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  1. Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    T. Münzel, A. Daiber & O. Hahad

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Correspondence to T. Münzel.

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T. Münzel, A. Daiber und O. Hahad geben an, dass kein Interessenkonflikt besteht.

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Münzel, T., Daiber, A. & Hahad, O. Luftverschmutzung, Lärm und Hypertonie. Herz 49, 124–133 (2024). https://doi.org/10.1007/s00059-024-05234-5

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