According to the World Health Organization, climate change is the “single biggest health threat facing humanity.”1 It affects cardiovascular health globally due to air pollution and extreme heat.
In Canada, air pollution is responsible for over 15,000 premature deaths annually2 and half of those are related to ischemic heart disease and stroke.3 Air pollution accounts for ~20% of cardiovascular disease deaths globally.4, 5 Extreme heat is the second major climate change-related factor that directly impacts cardiovascular health.6
Climate Change Working Group
In 2021, the CCS formed a Climate Change Working Group who develops and steers our work in this space. The working group’s objectives are to:
- Raise awareness about the effects of climate change and mitigation strategies;
- Promote and adopt individual and collective climate actions, including climate actions as a professional Society; and
- Advocate for policy change in support of climate action and cardiovascular health.
Climate Change Curriculum for Cardiovascular Training Programs
Air pollution and climate change have an impact on the risk of developing cardiovascular disease and the risk of dying of a cardiovascular event.
The Canadian Cardiovascular Society has proposed the following curriculum to be considered in the development of cardiovascular teaching programs. The following knowledge domains could be tailored to the learner whether they be medical/nursing students, internal medicine residents, cardiovascular trainees, nurse practitioners or cardiologists.
Proposed Climate Change Curriculum for Cardiovascular Training Programs
Submitted by Matthew Bennett, Jason Gencher, Isabelle Nault and Stephen Wilton on behalf of the Canadian Cardiovascular Society’s Climate Change Working Group
The cardiovascular trainee should be able to:
- Describe the processes (pathophysiology and scientific principles) by which climate change impacts cardiovascular health.
- Understand and engage in ways they can contribute to reducing the impact of climate change in their future practice.
- Apply that information meaningfully to patient care.
The specific knowledge domains are:
- Association of air pollution with Cardiovascular disease (CVD) (atherosclerosis, hypertension, atrial fibrillation, ventricular arrhythmias, cardiac arrest and cardiovascular mortality)
- Pathogenesis of how air pollution is associated with CVD
- Main sources of air pollution locally and globally
- Counselling for patients regarding risk reduction tactics during peaks of air pollution
- Mitigation strategies to decrease local and global air pollution
Extremes of Temperatures
- Effects of extremes of temperatures on patients with cardiovascular disease
- Mitigation strategies for patients at risk during extreme temperature times
- Scientific principles regarding how climate change occurs including knowledge regarding greenhouse gases (what are they, what causes them and how do they result in climate change) and the effect of climate change on the incidence of extreme weather events
- Consequences of climate change on health and health care delivery
- Emergency response plan for patients, medical practice, and hospitals during extreme weather events (extreme temperatures, fires, floods)
- Climate change initiatives relevant to cardiovascular care including:
- For patients: “green” diet, active transport
- For clinicians: audit medical system processes to decrease their adverse climate effects (office, in-person/remote care, hospital practice, procedure/operating rooms)
- For society: city planning (city density, facilitation of active transport, green spaces, shift diets to emphasize foods of plant origin, minimize food waste)
- Health benefits of climate action
- World Health Organization. Climate change and health. Accessed on November 30, 2021.
- Health Canada. Health Impacts of Air Pollution in Canada: Estimates of morbidity and premature mortality outcomes – 2021 Report. Accessed on April 5, 2022.
- Rajagopalan S, Landrigan PJ. Pollution and the Heart. N Engl J Med. 2021;385:1881-189.
- World Heart Federation. Air pollution and cardiovascular disease: A window of opportunity. Accessed on November 30, 2021.
- World Health Organization. Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. Accessed on November 30, 2021.
- Chaseling GK, Iglesies-Grau J, Juneau M, Nigam A, Kaiser D, Gagnon D. Extreme Heat and Cardiovascular Health: What a Cardiovascular Health Professional Should Know. Can J Cardiol. 2021;37:1828-1836.