Environmental Pollution and Health of Corinth Region. Corinthia Study

Introduction

Despite major advances in cardiovascular (CV) medicine during the last decades, deaths and morbidity from cardiovascular diseases (CVD) are increasing globally [1, 2]. It seems that population aging and population growth balances out the decline in age-specific death rates from CVD that could be attributed to more effective prevention and treatment strategies [2].

Interestingly, the progress in confronting CVD is evident around the world but notably heterogeneous. Regions with the fastest growing population dynamics experienced relative increase in CV deaths in line with global trends. In contrast, developed regions reported no detectable change or little decrease in CV mortality as rapid aging of the population offsets the declines in age-specific death rates [3]. Residual CV risk beyond traditional risk factors should be reassessed and further explored in the quest of new underlying mechanisms that could provide the substrate for innovative preventive interventions and therapeutic goals.

Under this prism, environmental factors constitute an important but underappreciated risk factor towards the development and progression of CVD [4]. Environmental exposure in variable pollutants is implicated in the derangement or propagation of adverse pathophysiological processes linked with atherosclerosis, including genetic, hemodynamic, metabolic, oxidative and inflammation parameters [4]. Recent studies suggest that chronic environmental stress is an important determinant of CVD risk, even below current regulatory standards for exposure levels [4, 5].

One of the most important studies in the field of environmental cardiology, the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) investigated the association between long-term air pollution exposure and the progression of subclinical atherosclerosis and the incidence of CVD at an urban dwelling population [6]. However no data exists concerning environmental pollution in rural or semi-rural areas. Therefore the purpose of the "Corinthia" study is to examine the impact of environmental pollution in indices of CV morbidity and mortality in a cross-sectional and longitudinal design.