Top Things to Know: Environmental Exposure and Pediatric Cardiology
Published: April 15, 2024
Prepared by Barbara Entl, MD, Science and Medicine Advisor, American Heart Association
- Approximately 300,000 synthetic chemicals are globally registered for usage; however, most research focuses on singular exposures, disregarding potential synergistic or antagonistic effects, thereby complicating the interpretation of findings.
- This scientific statement delves into the multifaceted influences of global warming, synthetic chemicals, maternal heat exposure, airborne pollutants, and various substances like lead and endocrine-disrupting compounds on cardiovascular outcomes.
- Global warming has been linked to cardiovascular implications affecting both adults and children, with both experimental and epidemiological investigations establishing a connection between maternal exposure to ambient heat and the occurrence of congenital heart defects (CHD), particularly conotruncal CHD and atrial septal defects.
- Recognized seasonal and geographical fluctuations in Kawasaki Disease (KD) incidence suggest a plausible role of environmental elements, such as airborne pollutants inducing oxidative stress and inflammation, contributing to the disease's etiology.
- Alternative pathways for Kawasaki Disease development may involve elevated ambient temperatures and increased levels of nitric oxide, sulfur dioxide, and suspended particulate matter. Heightened oxidative stress and inflammation resulting from air pollution may render genetically susceptible children more prone to developing KD.
- Early-life exposure to lead via inhalation or ingestion, for instance, through contaminated water or soil, exerts enduring health effects and potentially influences blood pressure throughout an individual's lifespan.
- Further, lead exposure detrimentally impacts cardiovascular health, including mortality, by inducing free radical damage to vital organs, particularly the kidneys, during early life stages.
- Endocrine-disrupting chemicals, such as phthalates, demonstrate an association with increased blood pressure and varying effects on lipid profiles, notably lower HDL-c and elevated LDL-c levels.
- Per- and polyfluoroalkyl substances, utilized for waterproofing and flame-retardant purposes and as indirect food additives, also exhibit associations with elevated lipid levels, disrupting HDL-c, LDL-c, and potentially triacylglyceride concentrations.
- The intricate web of environmental factors, ranging from global warming to chemical exposures like lead and synthetic compounds, underscores their substantial impact on cardiovascular health in children and adults. Addressing these complex interplays of environmental elements is paramount in safeguarding cardiovascular well-being across diverse populations and life stages.
Citation
Zachariah JP, Jone P-N, Agbaje AO, Ryan HH, Trasande L, Perng W, Farzan SF; on behalf of the American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Lifestyle and Cardiometabolic Health; and Council on Clinical Cardiology. Environmental exposures and pediatriccardiology: a scientific statement from the American Heart Association. Circulation. Published online April 15, 2024. doi: 10.1161/CIR.0000000000001234