Race and Medicine

Race and Medicine

Disclosures: The authors report no relevant financial disclosures.
August 26, 2020
2 min read

Pollution confers cardiac structure, function abnormalities in Hispanic, Latino patients

Disclosures: The authors report no relevant financial disclosures.
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Occupational exposures to vehicle exhaust, burning wood, metals and pesticides were linked to abnormal parameters of left ventricular and right ventricular systolic dysfunction in Hispanic and Latino participants, researchers found.

“These findings support the notion that where people live and work affects cardiovascular health,” Jean Claude Uwamungu, MD, cardiology fellow in training at Montefiore Health System/Albert Einstein College of Medicine, said in a press release. “Policies and interventions to protect the environment and safeguard workers’ health could reduce the risk of cardiovascular disease such as heart failure, especially among low-income occupations that have higher exposure to these harmful pollutants. Health care professionals should routinely ask patients about exposure to pollutants at work to guide prevention, diagnosis and treatment of early stages of heart disease.”

Air Pollution from smoke stacks
Source: Adobe Stock.

In the cross-sectional analysis published in the Journal of the American Heart Association, Melissa S. Burroughs Peña, MD, MS, general cardiologist at Stanford Health Care in Oakland, California, and colleagues analyzed data from 782 participants (mean age, 53 years; 52% women) aged at least 45 years who self-identified as Hispanic or Latino, which included Puerto Rican, Mexican, Dominican, Cuban, South American and Central American backgrounds.

All participants underwent transthoracic echocardiography to assess cardiac structure and function, including LV mass, LV systolic function and volumes, LV diastolic function, RV systolic function measures and LV global longitudinal strain. Participants also completed questionnaires on occupational exposures at their current and longest-held jobs. Exposures of interest included organic solvents, metals, vehicle exhaust, burning wood and pesticides.

Participants who were exposed to burning wood at their current job had decreased LV ejection fraction (3.1%; standard error [SE], 1; P = .002). This specific exposure was linked to decreased LVEF (2.7%; SE, 0.6; P < .0001), increased LV diastolic volume (6.7 mL; SE, 1.6; P < .0001), decreased RV fractional area change (0.02; SE, 0.004; P < .001) and worse LV global longitudinal strain (1%: SE, 0.3; P = .0009) after restricting the analysis to exposure at the longest-held job.

Pesticide exposure was associated a worse global longitudinal strain (0.8%: SE, 0.2; P < .0001).

Metal exposure was linked to increased stroke volume (3.6 mL; SE, 1.6; P = .03) and worse global longitudinal strain in the two-chamber view (1%; SE, 0.5; P = .04). This particular exposure was also associated with increased LV mass indexed to height (4.4 g/m2.7; SE, 1.9; P = .02) or body surface area (9.2 g/m2; SE, 3.8; P = .01).

“Occupational/environmental exposures to toxic substances potentially pose a threat to the cardiovascular health of working-aged individuals who are exposed,” Burroughs Peña and colleagues wrote. “Moreover, reducing exposure to these environmental toxicants, particularly burning wood and pesticides, in the general public is potentially an opportunity for primordial prevention of CVD.”