Why the EU faces a cardiovascular death burden
Cardiovascular disease remains the leading cause of death across the European Union. In 2022, more than 1.7 million people died from cardiovascular conditions, accounting for about one third of all deaths in the bloc. While genetics and individual risk factors matter, environmental conditions are increasingly recognized as a substantial contributor. Estimates suggest that at least 18% of cardiovascular deaths in the EU are linked to environmental factors. This means improving the environment could prevent roughly one in five deaths from heart and blood vessel diseases.
Where the environmental risk comes from
Environmental determinants influence heart health in multiple ways. Air pollution, heat exposure, noise, and limited access to healthy food and green spaces can increase the risk of hypertension, atherosclerosis, and other cardiovascular problems. Air pollution, in particular, has a well-established link to heart attacks, strokes, and heart failure. When wind and weather interact with urban design and industrial activity, vulnerable populations endure higher exposure, widening health disparities across the EU.
Air quality: the front line of prevention
Cleaner air has a direct, measurable impact on cardiovascular outcomes. Reducing fine particulate matter (PM2.5) and nitrogen dioxide (NO2) can lower blood pressure, decrease inflammation, and reduce the incidence of acute cardiac events. Many EU cities have begun policy shifts toward low-emission zones, electric public transportation, and better monitoring networks. While progress varies by country, the evidence is clear: improved air quality translates into fewer heart-related emergencies and hospitalizations.
Heat, climate and cardiovascular risk
Extreme heat, increasingly common with climate change, strains the cardiovascular system. Heat waves can lead to dehydration, electrolyte imbalances, and higher risks for people with existing heart conditions. Urban planning that expands shade, cooling centers, and green infrastructure can mitigate these effects and protect vulnerable residents during hot seasons.
Noise, housing and access to healthy choices
Chronic noise exposure is linked to elevated stress hormones and higher cardiovascular risk. Coupled with inadequate housing and limited access to fresh food and safe spaces for physical activity, noise contributes to a lifestyle pattern that harms heart health over time. Policies that reduce noise, improve housing quality, and ensure equitable access to recreational spaces are essential for long-term prevention.
<h2 what can be done: turning evidence into action
Turning the environmental risk evidence into tangible health gains requires coordinated policy action at local, national, and EU levels. Key steps include strengthening air quality standards, accelerating the transition to clean energy and transport, expanding urban green spaces, and investing in climate-resilient health systems. Public health campaigns can raise awareness about environmental risk factors and promote heart-healthy behaviors, such as physical activity, smoking cessation, and balanced diets.
Policy implications and the path forward
Estimates that 18% of cardiovascular deaths are preventable through environmental improvements highlight a clear policy incentive. By aligning environmental and health policies, the EU can reduce the burden of heart disease while advancing climate goals. This dual benefit—better air, safer cities, and healthier populations—underscores the urgency of prioritizing environment-focused prevention in health strategy discussions and budget planning.
