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Whether heart failure develops and how it progresses depends not only on physical factors, but also on external influences and the duration of exposure. This was discovered by scientists at University Medical Center Mainz in collaboration with an international research group in a systematic review study. According to the study, both individual risk factors, such as high blood pressure and lack of exercise, and stressful environmental factors, such as poor air quality, noise, and heat, are important starting points for preventing the disease and more effectively reducing the number of people affected. The study results were published today in the current issue of Nature Reviews Cardiology.
More than 64 million people worldwide are affected by heart failure, with more than four million in Germany. Despite modern drug therapies and interventional procedures, the chances of recovery are low and the long-term survival prognosis is poor: about half of those affected die within six years of diagnosis. This makes prevention all the more important. Until now, prevention and therapy have focused primarily on individual risk factors such as high blood pressure, diabetes, and genetic predisposition.
Dr. Omar Hahad, a scientist at the Department of Cardiology at the University Medical Center Mainz and first author of the study, has now investigated the topic more comprehensively together with other scientists. In their review study “The environmental exposome in heart failure risk and progression,” they focused on the so-called exposome, the totality of all environmental and living conditions to which a person may be exposed in the course of their life. They concluded that these factors can have a significant influence on whether heart failure develops and how it progresses.
Environmental factors have a long-term and simultaneous effect
The international research group, with participants from the USA, including Harvard Medical School, Yale School of Medicine, and Columbia University, evaluated numerous studies on the influence of individual environmental pollutants on heart failure. These include particulate matter, traffic and aircraft noise, extreme temperatures, artificial light at night, and toxic metals such as lead and cadmium. According to the study's findings, a decisive factor in the development of the disease is that these influences do not occur in isolation, but simultaneously, over many years and often already in early stages of life. “The continuous interaction of humans with the influencing factors of their environment leads to a considerable cumulative burden at the population level,” explains Dr. Hahad.
Environmental pollution exacerbates social inequalities
The risk of exposure to these factors is not the same for everyone. People with lower socioeconomic status are particularly affected. They are more likely to live in areas with poor air quality, higher noise pollution, and limited access to green spaces. At the same time, they often have limited access to preventive and therapeutic measures – and, as a result, higher mortality rates.
Thinking beyond medicine for prevention
Based on their findings, the authors of the study recommend taking a more holistic approach to the prevention and treatment of heart failure. In addition to medical measures, they advocate measures to protect air quality and protect against noise and heat.
Original publication:
Omar Hahad, Sojin Wass, Sanjay Rajagopalan, Shady Abohashem, Hua Hao, Ana Navas-Acien, Lavanya Bellumkonda, Kai Chen, Robert D. Brook, Khurram Nasir, Philipp Lurz, David E. Lanfear, Arvind Bhimaraj, Sadeer Al-Kindi.
The environmental exposome in heart failure risk and progression, Nature Reviews Cardiology (2026)
DOI: https://doi.org/10.1038/s41569-026-01247-1
Contact:
Dr. rer. Physiol. Omar Hahad
Department of Cardiology
University Medical Center Mainz
email Omar.Hahad@unimedizin-mainz.de
Pressekontakt:
Nadine Berger M. Sc.
Corporate Communications
University Medical Center Mainz
phone +49 (0)6131 17-8434
email pr@unimedizin-mainz.de
About the University Medical Center of the Johannes Gutenberg University Mainz
The University Medical Center of the Johannes Gutenberg University Mainz is the only medical institution of supra-maximum supply in the German state of Rhineland-Palatinate and an internationally recognized science location. Medical and scientific specialists at more than 60 clinics, institutes and departments work interdisciplinarily to treat around 403,000 patients per year. Highly specialized patient care, research and teaching are inseparably intertwined. Around 3,700 medicine and dentistry students as well as around 590 future medical, commercial and technical professionals are trained in Mainz. With a workforce of approximately 9,000 colleagues the University Medical Center Mainz is one of the largest employers in the region and an important driver of growth and innovation. Find more information online at http://www.unimedizin-mainz.de
Dr. rer. Physiol. Omar Hahad
Department of Cardiology
University Medical Center Mainz
email Omar.Hahad@unimedizin-mainz.de
Omar Hahad, Sojin Wass, Sanjay Rajagopalan, Shady Abohashem, Hua Hao, Ana Navas-Acien, Lavanya Bellumkonda, Kai Chen, Robert D. Brook, Khurram Nasir, Philipp Lurz, David E. Lanfear, Arvind Bhimaraj, Sadeer Al-Kindi.
The environmental exposome in heart failure risk and progression, Nature Reviews Cardiology (2026)
DOI: https://doi.org/10.1038/s41569-026-01247-1
Environmental conditions such as particulate matter, noise, and heat increase the risk of developing ...
Copyright: Canva/UM
Dr. Omar Hahad, first author of the study "The environmental exposome in heart failure risk and prog ...
Source: Oliver Rüther
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Environment / ecology, Medicine, Nutrition / healthcare / nursing
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