1 June 2019

Coronary Heart Disease continues to imperil global health with an unacceptable number of morbidity, consequential loss of life and the drain of world economies. It is justifiably prudent to address and target common and traditional risk factors and lifestyle practices as the root of causation and an effective way of attenuation of disease burdens.

However, there remain untapped, emerging relevant factors which come with urbanization and industrialization; among these factors are stress, air pollution, and noise levels which have become validated culprits of vascular disease. 

Historic and geographic evidence convincingly demonstrate the association of atherosclerosis and cardiovascular deaths with stress, pollution, and noise levels; these newly recognized elements have been all linked to the severity of atherosclerosis in modern societies as well as in mummies in ancient Egypt and tribes. Conversely, serene environments, low-level pollution, and greenery landscapes are associated with reduced levels of disease activity.

Recent studies have established a putative mechanism where the nexus is microparticles of pollution which elicit oxygen radicals which in trigger inflammation and generalized vascular injury. New fascinating evidence has also revealed a link between environmental stress such as noise or tension with brain triggering of inflammatory pathways and vascular injury.

In Lebanon, we witness an unchecked level of pollution and are exposed to a high degree of psycho-social stresses and economic uncertainties. Observations derived from national studies and more relevant from data generated from YADUNA reveal a high burden of subclinical disease among Lebanese women as reflected by elevated Coronary Calcifications, a robust marker of disease.

In light of these findings, it becomes imperative that our government and society take serious measures and assume proactive roles in introducing policies aimed at reducing noise resolve the problem of pollution and achieve a stable political and economic balance.

At YADUNA, we exert so much effort aimed at early detection of Coronary disease, advocating for healthy lifestyles, and in the treatment of traditional risk factors such as smoking diabetes and hypertension. We pledge to advocate for and collectively work on no less important, emerging factors such as pollution and noise which are inflicted by poor policies, bad politics, and suboptimal governance.

Samir Alam, MD, FACC, FRCP
Professor of Medicine - Cardiology
Chief of Staff
American University of Beirut Faculty of Medicine and Medical Center
YADUNA board of Trustees and Directors