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As Delhi-NCR battles deteriorating air quality, the health consequences of pollution are increasingly extending beyond respiratory illnesses. While coughing, wheezing, breathlessness and worsening asthma are among the most visible effects, there is another potentially life-threatening consequence that often goes unnoticed, the impact of polluted air on the heart.
Doctors are warning that periods of intense air pollution can coincide with a rise in cardiovascular emergencies, including heart attacks, strokes and dangerously elevated blood pressure.
In an interview with NDTV, leading pulmonologist Dr Arvind Kumar explained why the heart is among the organs most vulnerable to toxic air and why hospitals often see more cardiac emergencies following spikes in pollution.
" It was always thought that air pollution is a lung-centric problem. Now there is enough data to show that the lungs are the portal of entry and probably maximally affected. But there are three or four other areas where there is solid evidence available of serious damage being caused. First and foremost is the heart," Dr Kumar told NDTV.
Do Heart Attacks Increase After A Spike In Air Pollution?
According to Dr Kumar, the relationship between worsening air quality and cardiovascular emergencies is not merely theoretical. Doctors have observed a recurring pattern in which hospitals report more patients with heart attacks following sharp increases in pollution.
"Whenever there are peaks of pollution, suddenly, a couple of days later, all hospitals report a higher incidence of patients reporting with heart attacks," he said.
Elaborating on this association, Dr Kumar said that the rise in cardiovascular emergencies following pollution spikes has been documented internationally as well as in Indian hospitals.
"Every time there is a spike in these air pollution levels, a couple of days later, you will find a much higher percentage of people reporting to various casualties with heart attacks. There is a direct correlation," he told.
What About The Data Backing This Claim?
This observation is supported by Indian research. A study published in December 2025 in the peer-reviewed journal Discover Public Health, titled Piloting Surveillance of Environmental Risks and Cardiovascular Events in Delhi and Shimla, India, 2021, analysed 41,436 hospital admissions, including 11,494 cardiovascular events in Delhi. Cardiovascular events in Delhi saw a surge during pollution months.
The study, adjusted for temperature and humidity, found no statistically significant consistent association between air pollution and cardiovascular events in Shimla, highlighting the differences in exposure and local conditions.
What Is A Direct Link Then?
Fine particulate matter, especially PM2.5, is small enough to penetrate deep into the respiratory system. The particles and inflammatory signals generated in the lungs can affect the cardiovascular system.
According to Dr Kumar, once these toxic particles enter the body, their effects are not restricted to the respiratory tract.
"The lungs are the portal of entry. But there is enough data to show that the heart, the brain and several other organs are also being affected by air pollution," he explained
Air pollution can promote a pro-thrombotic state, making blood more likely to clot. If a clot blocks a coronary artery supplying the heart, it can trigger a heart attack. If it blocks blood supply to the brain, it can cause an ischaemic stroke.
Long-term exposure to particulate pollution is also associated with oxidative stress, inflammation and accelerated atherosclerosis, the gradual accumulation of fatty deposits inside arteries.
Heart Patient? Here Is Why You Are At Risk
Pollution exposure can have both immediate and cumulative effects.
Short-term exposure during a pollution spike can act as a trigger for an acute cardiovascular event, particularly in people who already have underlying risk factors.
Long-term exposure, meanwhile, contributes to the development and progression of cardiovascular disease.
People with existing coronary artery disease, hypertension, diabetes, heart failure and other metabolic conditions may be particularly vulnerable.
A separate systematic review published in the British Medical Journal also found an association between short-term air pollution exposure and an increased risk of stroke.
How To Protect The Heart?
Dr Kumar says personal protection becomes particularly important when air quality deteriorates, especially for elderly people and those with pre-existing heart or lung conditions.
During his conversation with NDTV, he recommended avoiding unnecessary outdoor exposure, particularly for vulnerable individuals.
His advice includes:
- Morning walks and outdoor running should be postponed or shifted indoors.
- If stepping outdoors, wear a properly fitted N95 mask. Cloth masks and surgical masks do not provide equivalent protection against fine particulate matter.
- Consider using an air purifier at home, particularly if elderly people, young children or individuals with pre-existing illnesses live there.
- People with existing heart disease should continue their prescribed medication and consult their treating physician if symptoms worsen.
Dr Kumar also cautioned that air purifiers can improve indoor air quality by reducing particulate matter, but there is not yet conclusive evidence that their use alone translates into measurable population-level reductions in cardiovascular events.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.