Climate change is one of the most pressing challenges of the 21st century, and its effects extend beyond rising temperatures and extreme weather events to also pose significant risks to human health.
As the impact of climate-related health issues becomes more evident, the urgency of addressing these challenges is at an all-time high. This is especially critical for vulnerable populations who face increased health risks and disparities due to factors such as marginalization, discrimination, or limited access to resources.
Heart disease risks are also on the rise, exacerbated by the environmental shift. Poor air quality, extreme heat, and more frequent natural disasters are increasingly linked to cardiovascular problems.
Smoke and air pollution (the haze from the 2023 forest fires in northern Quebec and Ontario, and more recently, the wildfires that ravaged Los Angeles are two examples) can have harmful effects on heart health.
Pollutants in the air are associated with a range of cardiovascular issues, including increased inflammation, elevated blood pressure, a higher risk of heart attack and stroke, disruptions in heart rhythm, and the worsening of pre-existing heart conditions.
Moreover, rising temperatures and shifting environments expose humans to new viruses and bacteria. If there’s a heart-related science lesson to be had from the COVID-19 pandemic, it’s that these infections can reek havoc on the heart and vascular system.
Heat and the heart
Jennifer Reed, PhD, a scientist and chair of cardiac rehabilitation at the Ottawa Heart Institute, explained that extreme heat places additional strain on the heart.
During extreme heat, the heart works harder to pump blood to the skin’s surface to cool the body, she said. “This extra stress can be life-threatening, particularly for individuals with existing cardiovascular disease or those taking heart medications.”
Katey Rayner, PhD, the Heart Institute’s chief scientific officer and vice president of research, is concerned about how to protect people with heart disease from these new environmental risks, especially in the context of prevention and rehabilitation.
“During heatwaves, people are often told not to exercise outdoors,” she noted. “But if heatwaves become more frequent and last for weeks on end, what are we supposed to tell people? What is safest and best for heart health long-term?”
While it is possible to manage the short-term damage to heart health through medication, the long-term, interacting and cumulative impacts of these environmental changes remain poorly understood. It’s these effects – the ones that have the potential to worsen the risk of heart disease – that scientists like Rayner and Reed are only beginning to explore.
A comprehensive vision
As the head of research at the Ottawa Heart Institute, Rayner is bringing together wide-ranging research teams and health partners from across Canada under a globally unique initiative called PANTHR, which stands for PAthogenic & New environmental Threats to cardiovascular Health & Resilience.
She is positioning the Ottawa Heart Institute to lead the world in creating new, integrated ways to investigate how environmental factors like air pollution, rising temperatures and exposure to emerging pathogens affect cardiovascular risk at both the individual and population levels.
“We want to learn how to protect our patients by better understanding how environmental stressors influence heart disease,” she told The Beat. “This research could fill a significant gap in our knowledge and lead to innovations in how we deliver care in our communities.”
In addition to environmental factors, Rayner’s team recognizes the need to better understand the role of infections – such as pneumonia, COVID-19, and the flu – in cardiovascular health. Although these infections are known to increase heart disease risk, doctors don’t usually ask about past infections when assessing heart health.
PANTHR’s goal, Rayner said, is to understand and address the combined effects of climate change, social factors, and cardiovascular disease on individual and community health.
"By clearly showing the cardiovascular risks, people can better understand how to reduce them, healthcare providers can offer targeted treatments early on, and policymakers can choose the best strategies to improve health and well-being in high-risk communities," she said.
For example, one approach scientists at the Ottawa Heart Institute are connecting through PANTHR is an expansion of wastewater analysis.
Ottawa researchers have developed groundbreaking methods to track COVID-19 and influenza. Although these wastewater monitoring approaches have been taken up around the world, they have not yet been applied to study the long-term cardiovascular risks associated with infections or the cumulative effects of multiple infections over time.
By connecting these and many other leading-edge research activities across Canada, scientists hope to gain a better understanding of who is most vulnerable to the heart health consequences of climate change, and how we can best prevent and treat them.
Using data for more personalized care
Rayner envisions a future where the Ottawa Heart Institute can use relevant climate data to deliver more personalized care, allowing doctors to craft precise, individualized prevention and treatment plans that lead to better outcomes.
For instance, a patient with moderate cholesterol might have been considered too low risk to benefit from treatment, but that diagnosis changes if their cardiovascular risk is increased by environmental factors like air pollution or past infections.
Achieving PANTHR’s exciting vision of understanding how these factors intersect and influence each other will require the development of a comprehensive simulation model to assess cardiovascular risks and interventions. With this integrated data, the team will be able to identify the biological changes that result and develop new treatments that target them directly.
The model will also identify which communities are most vulnerable to the combined effects of climate change, infectious disease, socioeconomic factors and heart conditions. The team is working with community partners who will be able to create community-driven prevention strategies that reduce their specific cardiovascular risks across all these factors.
However, integrating these complex variables won't be easy. It will require cutting-edge technology, sustained funding, and strong community engagement to overcome the challenges ahead.
Preparing for the future: Why this research matters
“For many heart patients, the daily realities of air pollution, extreme heat and dangerous infections are not abstract problems – they’re challenges they face every day,” said Jennifer Reed. “Understanding how these environmental changes influence their health is crucial in offering them better, more personalized care.”
Rayner and her team believe the Ottawa Heart Institute is well-positioned to get there.
“Now is the time to invest in this crucial research, as the longer we wait, the greater the challenge will be.”
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