A special communication from the world’s leading cardiology associations states that addressing the causes of environmental stressors, such as pollution and climate change, will help reduce the burden of cardiovascular disease (CVD) worldwide. The first joint statement from the European Society of Cardiology (ESC), the American College of Cardiology (ACC), the American Heart Association (AHA) and the World Heart Federation (WHF) that highlighted the crossroads of environmental stressors and cardiovascular health was published in the Journal of the American College of Cardiology on Tuesday. “Nature-positive strategies, which prioritize the restoration, preservation, and sustainable management of ecosystems, offer a powerful approach to achieving planetary health goals while mitigating pollution and its associated cardiovascular health impacts,” the investigators wrote. Thomas Münzel, MD, of the University Medical Center Mainz and the German Center for Cardiovascular Research, Germany, led the authorship of this paper. CVD is the number one cause of death worldwide. Traditional risk factors for CVD are well-known, such as smoking, diabetes, sedentary lifestyle and poor diet. Recent research has shed some light on the relationship between environmental factors and heart health, and the results demonstrate significant risks associated with all types of pollution. Pollution comes in many forms: air, chemical, water, soil, noise and light. Climate change inducing extreme temperatures as well as disasters, like wildfires and hurricanes, is creating a more volatile environment. Research shows that environmental risk factors (ERFs) now contribute to more cardiovascular deaths than other risk factors, but the public is less aware of these impacts. Healthcare professionals are also not fully aware of the crossover between environmental risks and CVD. The statement highlighted the systems-level framework that corresponds to toxic environmental exposures. Many environmental risk factors come from provisioning systems, such as transportation, food production and waste management. So how can this be balanced? A combination of strategic urban planning, actionable public health policy for ERF reduction, community engagement and awareness, financial planning and collaborative governance can create the environment needed to promote wellness and health across countries. Global guidelines should be developed and maintained. For example, communities and policymakers can work together to create green spaces, reduce emissions, form sustainable transit systems and work towards producing clean energy. Disparities exist — some populations are more at risk or harmed than others. These need to be addressed as well. “Our message is clear: cleaner air, quieter cities and a stable climate are not solely environmental goals, they are essential for heart health and for reducing the CVD burden globally,” Dr. Münzel said in an ESC press release on Tuesday. Professor Amam Mbakwem, MD, Vice President of the WHF, also commented during the press release, “To treat and prevent cardiovascular diseases, we must tackle the root causes and the increasing pressure of environmental risks. Intense exposure to air pollution and other forms of contamination take their toll especially on the most vulnerable. It’s imperative that all sectors act now and play their part to reduce and mitigate risks so that cardiovascular health for all becomes reality.” Source: Münzel T, Lüscher T, Kramer CM, et al. Cardiovascular health: Acting locally for global impact in a changing world. A statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation. J Am Coll Cardiol. 2026 January 20 (Article in Press). Image Credit: Orawan – stock.adobe.com