site.btaAir Pollution Increases Risk of Heart Attacks, Strokes but Has Been Ignored for Decades: Dr. Alexander Nossikoff

Air pollution is clearly an extremely important risk factor for heart attacks and strokes that has been ignored for decades, BTA learned from cardiologist Dr. Alexander Nossikoff, who participated in a seminar for journalists organized by the "Air for Health" association. “The most harmful are fine particulate matter of 2.5 micrometers and we have long noticed that when there are cold foggy days, days of no wind and high concentration of these particles, the incidence of heart attacks and strokes is higher,” he added, pointing out that this fact has been studied and proven not only in Sofia. In the capital, foggy and windless days are usually at the end of December, in January and February.

“Our explanation is that fine dust particles have a pro-inflammatory effect - they lead to inflammation of the plaque in the arterial vessel,” Dr. Nossikoff said in response to a question about the role of fine dust particles in the occurrence of a heart attack or stroke. “Most likely, fine particulate matter not only has a local effect on the lungs, but also enters the blood circulation, leading to vascular inflammation, thus increasing the risk of heart attack and stroke. In addition, we also now know that some patients have accumulated microplastics in their carotid arteries that the plaque has taken up from the environment,” the doctor explained.

According to him, serious consideration should be given to how many days in a lifetime a person has been exposed to fine particulate pollution. “There is no such analysis, but indirectly, if you analyse the cardiovascular mortality in Albania, in Greece, in Turkiye, you can see that it is significantly lower compared to the data for Bulgaria, Kosovo and North Macedonia,” he said. One possible explanation for the lower mortality rate, he said, is that these countries have extensive sea borders, the wind blows much more and the air quality is much better. Another possible explanation for the lower level of cardiovascular deaths in Greece, Turkiye and Albania is their adherence to the Mediterranean diet.

Solid fuel heating, which is common in Bulgaria, also leads to a lot of air pollution, the cardiologist added.

The lowest incidence of cardiovascular disease is reported in France, Dr. Nossikoff further pointed out. According to him, this is due to lower stress levels, higher quality food, cleaner air, moderate diet, and drinking more water.