1 in 5 cardiovascular deaths could be prevented by improving the environment

Not only obesity, smoking, and alcohol consumption increase the risk of heart attacks and strokes. According to the latest analysis by the European Environment Agency (EEA), cardiovascular diseases are at least 18% attributable to environmental factors. That is why it is worth fighting for cleaner, quieter, and greener surroundings.

Huge costs, millions of victims

In 2022, more than 1.7 million Europeans died from cardiovascular causes – that was one third of all deaths that year and the leading cause of mortality in Europe. Each year, 6 million new cases are diagnosed, dramatically increasing the burden on healthcare systems. The scale of this tragedy continues to grow.

Research published in 2023 in the European Heart Journal shows that cardiovascular diseases cost Europe €282 billion annually. Of this amount, €155 billion is spent directly on medical care, accounting for as much as 11% of all healthcare expenditure in the EU. The most costly are coronary heart disease and cerebrovascular disorders, such as strokes.

Some risk factors cannot be influenced: these include age, sex, race, and genetic predisposition. Others, such as diet or lifestyle, depend largely on individual choices. Yet the impact of the environment and climate is still discussed far too little.

Cardiovascular diseases and the state of the environment

According to the EEA analysis, environmental factors are responsible for 18% of cardiovascular deaths and 17% of the total disease and mortality burden. In Poland, this rate reaches as high as 23.69% – only Bulgaria fares worse (23.98%). This means that nearly one in four Poles dying from a heart attack or stroke could have lived if environmental conditions had been improved.

The key problem is air pollution, which, according to the EEA, is responsible for 130,000 cases of ischemic heart disease and stroke every year. Fine particulate matter (PM2.5), nitrogen oxides, and ozone are considered the most dangerous.

Cardiovascular diseases are also linked to noise from road, air, and rail traffic. What might seem like a mere inconvenience actually leads to chronic stress and sleep disturbances. As a result, a persistent, systemic inflammatory state develops in the body. Every year, 66,000 deaths in the EU are attributed to noise generated by transport.

Another threat is exposure to hazardous chemical compounds, particularly heavy metals, benzene, and polycyclic aromatic hydrocarbons. Lead alone accounts for about 2–4% of cardiovascular deaths. Growing concerns are also linked to phthalates and so-called forever chemicals (PFAS), increasingly detected in water and the environment. The phthalate bis(2-ethylhexyl) is responsible for 27,000 deaths among Europeans aged 55 to 64.

We should not forget about heatwaves, which are a direct consequence of climate change. Cardiac patients are particularly sensitive to high temperatures, and on hot days their risk of hospitalization rises by 16%.

One health – what needs to change

The authors of the analysis emphasize that environmental and climate action is the most effective way to reduce the risk of cardiovascular diseases. However, this requires a broad, cross-sectoral approach. The EU’s One Health initiative provides a framework for such cooperation, highlighting the interconnections between public health, the well-being of plants and animals, and the natural environment as a whole.

The top priorities today are combating air pollution, phasing out cardiotoxic substances, and reducing transport noise in cities. Healthcare systems should implement strategies to mitigate the impacts of climate change, particularly by supporting the most vulnerable social groups.

EEA experts also stress the importance of nature-based solutions: parks, green corridors, and blue spaces, which lower temperatures, reduce noise and air pollution, and promote heart-healthy recreation.