Research from two studies in different European cities1,2 highlights that urban noise pollution has a significant negative impact on heart health, according to data presented at the ESC Congress 2024.
“The DECIBEL-MI study shows that young patients aged 50 years or younger who had a myocardial infarction (MI) were exposed to higher noise levels than the general population. The study shows that urban noise could significantly increase the risk of early Onset MI in youth with low traditional risk factors Inclusion of noise exposure in risk prediction models helps to accurately identify those at risk, leading to better targeted prevention.
The DECIBEL-MI study included 430 consecutive patients living in Bremen, Germany, aged 50 years or younger with acute myocardial infarction, who were admitted to a local heart center. When residential noise exposure levels were calculated, the researchers observed a higher incidence of noise exposure compared to the general population in the same area. Patients with MI and a low LIFE-CVD score (≤2.5%), indicating a low level of traditional risk factors such as smoking or diabetes, had significantly higher noise exposure compared to those with a high LIFE-CVD score. This is critical because traditional risk assessment models may underestimate cardiovascular risk in young people who are otherwise considered to be at low risk. By incorporating noise exposure into these models, it is possible to more accurately identify those at increased risk for MI, allowing for better targeted preventive measures and interventions.
A separate study in France assessed the impact of environmental noise exposure on prognosis after a first MI.
In the ENVI-MI study, we found a strong association between exposure to urban noise, particularly at night, and a worse prognosis 1 year after the first myocardial infarction.”
Marianne Zeller, study researcher, professor from the University of Burgundy and the Hospital of Dijon, France
Data from the French Observatory (RICO) database were collected for 864 patients hospitalized for acute myocardial infarction who survived at least 28 days after MI. At 1-year follow-up, 19% experienced a major adverse cardiovascular event (MACE, cardiac death, hospitalization for heart failure, recurrent MI, urgent revascularization, stroke, angina and/or unstable angina). Daily noise exposure levels measured at each patient’s home address (average noise level in decibels A [dB(A)]: 56.0 24 hours and 49.0 at night) were considered moderate and representative of a large part of the European population. Of note, there was a 25% increased risk of MACE for every 10 dB(A) increase in nighttime noise (hazard ratio 1.25, 95% confidence interval 1.09–1.43), regardless of air pollution , socioeconomic levels, and other confounding factors.
“These data provide some of the first insights that noise exposure can influence prognosis. If confirmed by larger prospective studies, our analysis could help identify new opportunities for environment-based secondary prevention strategies, including barriers noise for high-risk MI patients,” added Prof. Zeller.
