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Climate Cardiology: Why This New Specialty Might Be Needed

Climate change is a worldwide problem that’s having a devastating impact on human health. One of the most affected groups are those with cardiovascular disease (CVD), and according to an open access journal in BMJ Global Health, experts are calling for the need of a new healthcare specialty, climate cardiology, to help combat the effects these climate hazards have on cardiovascular health and the planet.

How Did We Get Here?

Greenhouse gases (GHGs) are the highest they’ve been in 800,000 years, causing a rise of global surface temperatures and associated climate change. Major sources of GHGs are fossil fuel burning, agriculture deforestation, meat production, and even healthcare. In fact, the healthcare sector alone contributes 4.4 percent of GHGs globally and 10 percent in the United States.

The continued rise of these emissions will have direct effects on global warming, such as extreme weather, air pollution, ecosystem collapse, and declines in global food production and nutrition quality. This has direct and indirect consequences on cardiovascular health, and the authors explain that:

• Extreme heat increases the risk of stroke and ischemic heart disease, especially for the elderly with underlying CVD. In 2019, rising temperatures were responsible for an estimated 93,000 CVD deaths globally.
• Ecosystem declines, such as desertification and ocean acidification, are leading to a shortage of nutritious foods like fresh produce, whole grains, and seafood. It’s currently estimated that by 2050, 25 million children might be undernourished, and cardiovascular health may worsen due to increased high-calorie and energy-dense foods replacing nutritious diets.
• Similarly, ecosystem collapse brought on by famine, floods, forest fires, and rising sea levels may lead to a rise in poverty, and climate refugees may be forced to go to places that are ill prepared to provide care for cardiovascular health.
• Air pollution has long been known as a detriment to human and environmental health and is responsible for nearly 3.54 million cardiovascular deaths globally.  

Opportunities for Change

According to experts, there are ways for the healthcare sector and policymakers to mitigate climate change and reduce the global burden of associated CVD. These include the following:

• A transition from red-meat to plant-based diets can reduce CO2 emissions and lower cardiovascular risk by cutting the amounts of consumed saturated fats, which is an established risk factor of CVD.
• A transition from vehicular to active transportation can combat obesity, diabetes, and atherosclerosis, which was responsible for nearly 639,000 cardiovascular deaths in 2019. Active transportation like cycling or walking would also reduce GHG emissions and the prevalence of CVD.
• Expansion of greenspaces could help mitigate climate change by reducing or removing CO2 from the atmosphere and provide closer proximity to vegetation, which is known to lower stress, physical inactivity, diabetes, and CVD.
• A transition to clean energy by cutting fossil fuel emissions could provide the greatest opportunity to protect both the planet and human health. Currently, overly 90 percent of the global population is exposed to harmful levels of PM2.5, which contributed to over 3.5 million cardiovascular deaths in 2019. 
• Similarly, inefficient stoves expose two billion people to harmful levels of PM2.5. Providing clean stoves could improve cardiovascular health and cut GHG emissions.
• Several interventions to practice resource efficiency in healthcare could promote cardiovascular health and reduce its carbon footprint. These include promoting prompt telemedicine visits, local ambulatory care, empowered self-care, reducing overtreatment and overprescribing, and investment in disaster planning and education to prepare for extreme weather events and its associated effects.

Experts also stress that these attempts should be made to protect individuals of all ages as the burden of climate change accumulates as early as childhood and manifests as cardiovascular events later in life. As climate change continues to get worse, prompt action is needed, and a new field of climate cardiology could provide the opportunity for dedicated efforts to protect both patients and the planet.