Evidence map›Paper›PMID 41582253›Full record

ReviewNature reviews. Cardiology2026

The environmental exposome in heart failure risk and progression.

Omar Hahad, Sojin Wass, Sanjay Rajagopalan, Shady Abohashem, Hua Hao, Ana Navas-Acien, Lavanya Bellumkonda, Kai Chen, Robert D Brook, Khurram Nasir and 4 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Omar HahadDepartment of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.ORCID http://orcid.org/0000-0001-7823-7671
Sojin WassDepartment of Cardiology, Cleveland Clinic, Cleveland, OH, USA.
Sanjay RajagopalanHarrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Shady AbohashemCardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-5033-8881
Hua HaoGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Ana Navas-AcienDepartment of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
Lavanya BellumkondaDivision of Cardiology, Yale School of Medicine, New Haven, CT, USA.
Kai ChenDepartment of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
Robert D BrookDepartment of Internal Medicine, Wayne State University, Detroit, MI, USA.
Khurram NasirDepartment of Cardiology, Houston Methodist, Houston, TX, USA.
Philipp LurzDepartment of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
David E LanfearDepartment of Internal Medicine, Division of Cardiovascular Medicine, Henry Ford Health + Michigan State University Health Sciences, Detroit, MI, USA.
Arvind BhimarajDepartment of Cardiology, Houston Methodist, Houston, TX, USA.ORCID http://orcid.org/0000-0003-3042-8027
Sadeer Al-KindiDepartment of Cardiology, Houston Methodist, Houston, TX, USA. sal-kindi@houstonmethodist.org.

Funding

Diversity Suppplement (CIRCADIAN) Circadian Disruption as Mediator of Cardiometabolic Risk in Air PollutionR35ES031702 · NIEHS · CASE WESTERN RESERVE UNIVERSITY · PI Sanjay Rajagopalan · 2021 to 2026
$5.9M
NIEHS NIH HHS R35 ES031702
6 · The paper itself

Abstract

Environmental exposures have a crucial role in the incidence and progression of heart failure (HF) by exacerbating genetic predisposition and other pathophysiological mechanisms. The exposome - encompassing pollution, climate and the urban environment - and the biological responses to these factors shape cardiovascular health in complex ways. Air, noise and light pollution, exposure to toxic metals, and extremes of temperature adversely affect HF outcomes. Social determinants of health, including socioeconomic status, amplify these environmental risks, disproportionately affecting vulnerable populations. Conversely, green spaces and walkable neighbourhoods are linked to a reduced risk of HF, improved vascular health and medication adherence. Emerging evidence suggests that environmental stressors influence HF outcomes from early life by altering gene expression through epigenetic mechanisms. Despite these insights, research gaps remain. Future studies must integrate environmental, genetic and multiomics data to refine risk prediction and guide targeted public health interventions. A comprehensive understanding of the exposome in the aetiology of HF is essential for developing prevention strategies that address both biological and social determinants of cardiovascular health.

Indexed as

Environmental ExposureExposomeHeart FailureAnimalsDisease ProgressionGene-Environment InteractionGenetic Predisposition to DiseaseHumansRisk AssessmentRisk Factors

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.