Transportation noise pollution and cardiovascular disease

Epidemiological studies have found that transportation noise increases the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischaemic heart disease. According to the WHO, ≥1.6 million healthy life-years are lost annually from traffic-related noise in Western Europe. Traffic noise at night causes fragmentation and shortening of sleep, elevation of stress hormone levels, and increased oxidative stress in the vasculature and the brain. These factors can promote vascular dysfunction, inflammation and hypertension, thereby elevating the risk of cardiovascular disease. In this Review, we focus on the indirect, non-auditory cardiovascular health effects of transportation noise. We provide an updated overview of epidemiological research on the effects of transportation noise on cardiovascular risk factors and disease, discuss the mechanistic insights from the latest clinical and experimental studies, and propose new risk markers to address noise-induced cardiovascular effects in the general population. We also explain, in detail, the potential effects of noise on alterations of gene networks, epigenetic pathways, gut microbiota, circadian rhythm, signal transduction along the neuronal–cardiovascular axis, oxidative stress, inflammation and metabolism. Lastly, we describe current and future noise-mitigation strategies and evaluate the status of the existing evidence on noise as a cardiovascular risk factor. In this Review, Münzel and colleagues summarize the epidemiological evidence on transportation noise pollution as a cardiovascular risk factor, discussing mechanistic insights for the adverse cardiovascular effects of noise pollution and highlighting new risk markers of noise-induced cardiovascular effects as well as promising noise-mitigation strategies. Key points Noise is associated with cardiovascular diseases, such as arterial hypertension, coronary artery disease, heart failure and arrhythmia, and should therefore be considered a cardiovascular risk factor. Noise-induced stress increases blood pressure, stress hormone levels, endothelial dysfunction, oxidative stress, NADPH oxidase 2 (NOX2) activity, nitric oxide synthase uncoupling and vascular inflammation in mice, all of which are prevented by NOX2 deficiency. Translational field studies in healthy individuals and patients with heart disease established that short-term simulated aircraft and railway noise impairs sleep quality and increases stress hormone levels, blood pres