Pollution and cardiovascular health in Malta : a review

The leading cause of global mortality is cardiovascular disease (CVD) and in 2016 alone over 17 million premature deaths were attributed to CVD.1 Whilst previously there was only weak evidence to suggest an association of air pollution as a risk factor for CVD2, in recent years, the impact of air pollution has emerged as an independent, strong and modifiable risk factor for CVD. The importance of air pollution on CVD is now being considered above other more traditional factors such as high cholesterol and reduced physical activity.3 Exposure to fine particulate matter has been shown to increase the risk of acute coronary syndromes, yet more concerning are the studies which have shown the greater extent of its effects over a longer period of time, reducing life-expectancy by a number of years and being responsible for 19% of cardiovascul­­ar mortality (>3 million deaths).1 The purpose of this review is to identify significant studies investigating air pollution and its effects on cardiovascular health while also considering our situation in Malta, as a small, highly populated country.peer-reviewe