Two separate studies presented at the ESC Congress 2024 in London have highlighted the negative impacts of urban noise pollution on cardiovascular health. The findings suggested that incorporating noise exposure into risk prediction models could improve the identification of individuals at risk for myocardial infarction and that higher noise levels were associated with worse prognosis after a first myocardial infarction.
The DECIBEL-MI study, conducted in Bremen, Germany, researchers recruited 430 consecutive patients aged 50 years or younger who were admitted to a local heart center with acute myocardial infarction (MI). The researchers calculated residential noise exposure levels and observed a higher incidence of noise exposure among these patients compared with the general population residing in the same region. Patients with MI and a low LIFE-CVD score (≤ 2.5%), indicating a low level of traditional risk factors such as smoking or diabetes, endured significantly higher noise exposure compared with those with a high LIFE-CVD score. This finding suggested that traditional risk assessment models might underestimate cardiovascular risk in young individuals who are otherwise considered low risk.
The researchers indicated that incorporating noise exposure into risk prediction models could help accurately identify at-risk individuals, leading to more targeted prevention strategies. They emphasized the need for public health strategies to reduce noise pollution and improve cardiovascular health in young populations.
The ENVI-MI study, conducted in France, assessed the impact of environmental noise exposure on prognosis after a first MI. Data from the French observatory database (RICO) were collected for 864 patients hospitalized for an acute MI who survived at least 28 days after the event. At the 1-year follow-up, 19% of the patients experienced a major adverse cardiovascular event (MACE), which included cardiac death, rehospitalization for heart failure, recurrent MI, emergency revascularization, stroke, angina, and/or unstable angina. The daily noise exposure levels measured at each patient's home address were considered moderate and representative of a large part of the European population, with an average noise level of 56.0 dB(A) over 24 hours and 49.0 dB(A) at night.
Notably, there was a 25% increased risk of MACE for each 10 dB(A) increase in noise during the night (hazard ratio = 1.25, 95% confidence interval = 1.09–1.43), independent of air pollution, socioeconomic levels, and other confounding factors. The researchers stated that these data provided some of the first insights into how noise exposure can affect prognosis after MI. She suggested that if confirmed by larger prospective studies, this analysis could help identify new opportunities for environment-based secondary prevention strategies like noise barriers for patients at high-risk of MI.
The researchers expressed that urgent measures are needed to reduce the burden of cardiovascular disease by addressing environmental factors such as noise pollution. Public health strategies aimed at reducing noise exposure could play a crucial role in improving cardiovascular health outcomes, particularly in urban populations.
