Background: 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.
Methods: 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.
Conclusions: 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.