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The many faces of inflammation in the cardiovascular arena: The importance of air pollution
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Indeed, as summarized in the graphical abstract accompanying this text, the larger realm of environmental factors also seems to be related to a heightened inflammatory status connecting aggressors (pollution, noise, environmental stress, and others) to hypertension.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2–8</span></a> Furthermore, this connection has been recently exposed by the current pandemic (taking less noise and less pollution as the positive side of the Covid pandemic lockdowns)<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We have also been following these authors for their very serious work in determining the prevalence of hypertension in Portugal.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">10,11</span></a> In this respect, other figures (for the prevalence of hypertension) have been put forward,<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> but the group has presented valid and interesting work. In this paper, a correlation is sought between the systolic and diastolic values of a previous registry (The Portuguese Health Examination Survey) obtained in 2015<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> and air quality monitoring obtained in the same year, according to the Portuguese Environmental Agency. However, despite the correct methodology, there was no impact between the obtained results on breathable Particulate Matter and blood pressure values. So, the publishing of a negative study also needs courage and emphasizes the authors’ scientific rigor.</p><p id="par0020" class="elsevierStylePara elsevierViewall">As the authors explain, the long distance between participant residence and air quality monitoring stations, might contribute to the negative results. Other confounding factors may be important, especially those related to the plethora of factors influencing hypertension and the difficulty to factor in all the confounders. Indeed, hypertension is a complex syndrome, consequently it is very hard to study even in simpler contexts.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The discussion is exhaustive and true to the most recent scientific evidence, especially with regard to the difference between the demonstrated minor effects of pollution in hypertension in European countries, as opposed to other regions of the world. It is well-known that poorer underdeveloped countries have a higher connection between hypertension (and other cardiovascular risks) and pollution. One must understand that in many of these countries people still use firewood combustion for their cooking, so the number of inhaled particles is much higher, this is called combustion environmental risk,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> understandably lower in developed countries.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we truly enjoyed this work and believe it has merit, particularly because – as the authors duly emphasize – it is the first Portuguese reports on the matter. Further work will certainly follow. As for the future role of inflammation in the cardiovascular arena, even though we have reasonable doubts on the proposed use of anti-inflammatory drugs for the treatment of vascular hypertension,<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> we truly believe that the ever-increasing knowledge on the complex vascular inflammation biology will be very important for the understanding of the ever growing connection between environmental factors and cardiovascular disease. Such are the “many faces of inflammation” that we are still trying to unveil … instinctively, we all feel that some (maybe many) present day environmental and social factors, including the ever-present global warming, are potentially bad. Let us hope that common sense and good science will help us fight such serious foes.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "xres1858008" "titulo" => "Graphical abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Graphical abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0005"></elsevierMultimedia></p></span>" ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 752 "Ancho" => 1333 "Tamanyo" => 97532 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Investigating the association between ambient particulate matter (PM<span class="elsevierStyleInf">10</span>) exposure and blood pressure values: results from the link between the Portuguese Health Examination Survey and air quality data" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. 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| Ano/Mês | Html | Total | |
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| 2024 Novembro | 7 | 6 | 13 |
| 2024 Outubro | 45 | 33 | 78 |
| 2024 Setembro | 45 | 28 | 73 |
| 2024 Agosto | 45 | 29 | 74 |
| 2024 Julho | 47 | 34 | 81 |
| 2024 Junho | 53 | 39 | 92 |
| 2024 Maio | 38 | 20 | 58 |
| 2024 Abril | 42 | 26 | 68 |
| 2024 Maro | 39 | 28 | 67 |
| 2024 Fevereiro | 28 | 22 | 50 |
| 2024 Janeiro | 27 | 14 | 41 |
| 2023 Dezembro | 38 | 18 | 56 |
| 2023 Novembro | 34 | 34 | 68 |
| 2023 Outubro | 27 | 16 | 43 |
| 2023 Setembro | 31 | 22 | 53 |
| 2023 Agosto | 20 | 15 | 35 |
| 2023 Julho | 48 | 6 | 54 |
| 2023 Junho | 41 | 17 | 58 |
| 2023 Maio | 48 | 33 | 81 |
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