The co-benefits of climate change mitigation strategies on cardiovascular health: a systematic review

Background: Climate change is a significant threat to global human health and a leading cause of premature death. Global warming, leading to more extreme weather (in particular extreme heat events), and air pollution has been associated with increased cardiovascular disease (CVD) morbidity and mortality. According to the Global Burden of Disease Study 2019, 62% of the deaths attributable to climate change were from CVD. Climate change mitigation is a slow, steady process, and the concept of co-benefits has arisen to promote climate action. This systematic review examines how numerous mitigation strategies, such as plant-based diets, increasing green spaces, increasing active transport, using renewable energy sources, and smoking cessation, may have the co-benefit of reducing CVD. Methods: A mixed methods systematic review with narrative synthesis was conducted on four databases, according to the PRISMA guidelines. The articles retrieved (published between 2012 and 2022) had a mitigation strategy as the exposure, and CVD related morbidity or mortality reduction as an outcome. Findings: The review found that renewable energy has a stronger association with cardiovascular co-benefits compared to emission reduction targets. Multimodal transport is more beneficial for both the climate and cardiac health than zero emission vehicles. Diet modification, such as Mediterranean and plant-based-diets, is positively associated with CVD reduction. Proximity to green spaces and reducing urbanisation may also improve cardiac health. Interpretation: This systematic review demonstrates that implementing four mitigation strategies - increasing renewable energy use, active transport, green spaces, and plant-based diets; could lead to the co-benefit of reducing CVD morbidity and mortality. Furthermore, it illustrates the importance of plant-based diets and active transport to improve cardiovascular health. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.