Unveiling the exposome: How environmental stressors impact cardiovascular health

Understanding the impact of environment and lifestyle stressors on your heart could help prolong healthspan.

Environmental stressors, ranging from air pollution and noise to unhealthy urban planning and climate change, have long been recognized as significant risk factors for cardiovascular disease. Now, in an article published in Nature Review Cardiology, an international team of researchers have shed light on the profound effects of these environmental stressors on the cardiovascular system, employing the emerging exposome concept.

Longevity.Technology: The exposome concept encapsulates the cumulative lifetime exposure to all environmental risk factors and their subsequent impact on an individual’s health. By linking adverse environmental exposures to pathophysiological changes, chronic diseases and premature mortality, this emerging field of research provides a holistic understanding of the interplay between the environment and human health.

Within the cardiovascular domain, the application of the exposome concept unveils a compelling narrative, paving the way for innovative prevention strategies – strategies desperately needed given that cardiovascular disease remains the leading cause of death worldwide.

Global epidemiological studies have revealed that nearly two-thirds of annual deaths worldwide can be attributed to chronic non-communicable diseases, with cardiovascular ailments taking the top slot as the primary cause. This alarming trend is exacerbated by environmental stressors such as land, water, air and noise pollution, as well as unhealthy urban designs and sedentary lifestyles.

Environmental physicians estimate that a whopping two-thirds of chronic non-communicable diseases stem from environmental factors. Chemical pollution alone is responsible for 16 to 22 percent of global deaths (equivalent to 9 to 12.6 million lives). Within the exposome paradigm, these adverse health outcomes and premature mortality emerge as a result of harmful biochemical and metabolic changes incurred by multiple environmental exposures [1].

The recent article in Nature Review Cardiology presents select cardiovascular exposome studies that shed light on the associations between environmental exposures and detrimental health effects. Notably, these exposures have been linked to inflammation, adverse metabolic changes, dysregulated DNA methylation (epigenetic changes), increased blood pressure and other cardiovascular complications.

One notable initiative in this field is the European Human Exposome Network, which was launched in 2020 with impressive start-up funding of €106 million. This ambitious project aims to investigate the environmental influences on the health of Europeans by screening over 22 million workers for workplace exposures, focusing on chemical toxins, noise and psychosocial stress. Additionally, more than 2 million subjects will undergo comprehensive investigations using diverse techniques to establish significant links between exposure and health outcomes.

To support exposome research, advanced tools and techniques are being developed. Mobile personal sensors enable the collection of lifetime data with high spatial and temporal resolution, while satellite-based exposure monitoring contributes to a comprehensive exposure history – however, challenges such as analytical limitations and the need for a complete lifetime exposure history, still remain to be overcome.

One particularly complex challenge lies in assessing the impacts of multiple exposures to environmental toxicants, as statistical and mathematical solutions are scarce. Overcoming these hurdles is essential to harness the full potential of the exposome concept in shaping prevention strategies, as emphasized by Professors Thomas Münzel and Andreas Daiber from the Center for Cardiology at the University Medical Center Mainz and the German Centre for Cardiovascular Research (DZHK).

Münzel and Daiber, who are authors on the papers, say: “The exposome concept is an important new approach to study environmental influences on health and may help to develop prevention strategies to reduce the risk of cardiovascular and other chronic non-communicable diseases [2].”

The authors emphasize the need for further research to comprehensively comprehend the exposome and explore its effects on various organ systems and disease states. Quantifying and accounting for individual exposures are crucial, as environmental factors heavily depend on factors such as location, occupation and individual behaviors [1].

The exposome concept presents a key approach to studying the influences of the environment on human health, particularly in relation to cardiovascular and healthspan. By unraveling the intricate connections between environmental stressors and adverse health outcomes, crucial insights that can pave the way for innovative prevention strategies can be gained. Understanding the impact of environmental stressors on cardiovascular health not only has implications for disease prevention but also holds the potential to extend healthspan and lifespan, as well as promoting overall wellbeing throughout an individual’s lifetime. By quantifying individual exposures and considering factors such as location, occupation and behavior, we can develop comprehensive strategies to mitigate environmental risks and foster longer-living healthier communities. While continued research is needed to unravel the full complexity of the exposome and its effects on different organ systems and disease states, we can begin to forge a path toward a future where individuals can enjoy extended healthspan and thrive in environments that prioritize their longevity and wellbeing.

[1] https://www.nature.com/articles/s41569-023-00873-3
[2] https://dzhk.de/aktuelles/news/artikel/ungesunde-umwelt-verursacht-herz-kreislauf-erkrankungen-das-exposom-konzept/