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Doctors always urge heart patients to stay fit and watch what they eat.
But they may soon add: Careful what you breathe.
That's the suggestion of new research published today in the medical journal Circulation. Based on research at Brigham Young University and LDS Hospital in Salt Lake City, the groundbreaking study showed that people suffer more heart attacks and other coronary events when winter pollution increases even for just a day or two.
"Our advice is to stay in and don't breathe a lot of this air," said Jeffrey L. Anderson, associate chief of cardiology at LDS hospital.
The BYU-LDS Hospital study included 12,000 heart patients with blockage in at least one artery. It lasted 12 years.
The research team monitored the patients with an eye on levels of "PM 2.5," the microÂscopic soot particles largely from fossil fuel burning in cars and trucks, coal plants and industry. In the end, they saw that an increase of 10 micrograms of PM 2.5 per cubic meter of air resulted in 4.5 percent more heart attacks and angina, a chest pain that occurs when your heart muscle does not get enough blood.
If pollution levels increased to the point state air quality officials declare the air is "unhealthful for sensitive groups," the number of coronary events would increase by 45 percent. Utah wintertime inversions sometimes include days with PM 2.5 at this level or higher.
Anderson noted that high-pollution warnings typically are discussed by doctors and their lung patients but not their heart patients.
"This [study] should change how we take care of heart patients," he said.
C. Arden Pope, an environmental epidemiologist at BYU and the study's lead author, said the results also suggest that public policy on air pollution may need to change.
While individuals can minimize their risk of a heart attack by watching what they eat, through moderate exercise and by not smoking, it's much harder to reduce the effects of air pollution.
"The reason the effects are so large is that so many of us are likely to be susceptible and the other is the exposure [to polluted air] is so ubiquitous," said Pope. "You can't stop breathing."
Heart disease is the leading cause of death in the nation and Utah.
"Certainly, there is a public policy issue here," said Pope.
Casey Hill, advocacy director for the American Heart Association's Utah office, pointed out that his agency noted the long-term effects of air pollution a couple of years ago. He does not foresee any new activism on the part of heart doctors and their patients on the issue at this point.
"We'll keep our eyes on things," he said.
Pope's work linking pollution to heart and lung hospitalizations and death have been used to fashion the nation's law on PM 2.5 and even withstood scrutiny when the law was challenged before the U.S. Supreme Court. Those past studies were done in collaboration with researchers from outside Utah, including Harvard University.
The current research team included Pope and Anderson, along with LDS Hospital's Benjamin D. Horne, Joseph D. Muhlstein, Dale G. Renlund and Heidi T. May. Muhlstein and Renlund have joint appointments at LDS and the University of Utah.
* Forecasters expect hazy days, foggy nights and pollution this week. Microscopic dust and pollution is expected to build in northern Utah valleys as cold and high pressure linger through the week and deepen this winter's first inversion.
* ''I wouldn't be surprised if we were in the yellow or even the red [high air-pollution alerts] at the end of the week,'' said Bob Dalley, director of the Utah Division of Air Monitoring.
Heart trouble
* Heart disease, Utah's and the nation's leading killer, accounts for 20 percent of all Utah deaths.
* About 2,900 Utahns a year die of heart disease.
* More than 15,000 are hospitalized for heart disease each year, at an average cost in 2005 of $28,000.
Source: Utah Department of Health