title: Environmental Factors and Hypertension.
abstract: Environmental factors are a major cause of poor health worldwide. The most solid evidence is for air pollution, leading to increased disability-adjusted life years. Outdoor temperature and other seasonal climate changes may also influence cardiovascular health, according to their direct modulation of air pollution. Moreover, an increasing body of evidence associates environmental exposure to noise with poor cardiovascular outcome, and in particular with hypertension.
  
  
  
  This review is aimed at reviewing current evidence about the role of these environmental factors in cardiovascular disease and specifically hypertension. In particular, the impact of air pollution, with its short-term and long-term effects, the outdoor temperature and noise pollution will be investigated.
  
  
  
  People belonging to low social classes, as well as children, women, older people and those with established cardiovascular diseases, seem to have a greater susceptibility to the effects of environmental stressors, recalling the concept of "environmental justice". The accumulating strong scientific evidence may thus support public health policies aimed at reducing social inequalities in cardiovascular health.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa. Italy.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Bruno
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa. Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Di Pilla
authors.affiliation: Department of Epidemiology Lazio Regional Health Service, Rome. Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Ancona
authors.affiliation: Danish Cancer Society Research Center, Copenhagen. Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa. Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gesi
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa. Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
authors.affiliation: Kardiologie I, Zentrum für Kardiologie, University Medical Center of Mainz, and DZHK-standort Rhein Main. Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Munzel
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa. Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Virdis
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D009622:Noise / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors
keywords: Air pollution; blood pressure.; hypertension; noise; outdoor temperature; particulate matter