Abstract
BACKGROUND: Chronic transportation noise is an environmental stressor affecting a substantial portion of the population. The World Health Organization (WHO) and various studies have established associations between transportation noise and cardiovascular disease (CVD), such as myocardial infarction, stroke, heart failure, and arrhythmia. The WHO Environmental Noise Guidelines and recent reviews confirm a heightened risk of cardiovascular incidents with increasing transportation noise levels. OBJECTIVE: We present a narrative review of the evidence from epidemiologic studies and translation studies on the adverse cardiovascular effects of transportation noise. METHODS: We describe the results of a recent Umbrella+ review that combines the evidence used in the 2018 WHO Environmental Noise Guidelines with more recent (post-2015) high-quality systematic reviews of original studies. High-quality systematic reviews were included based on the quality of literature search, risk of bias assessment, and meta-analysis methodology using AMSTAR 2. RESULTS: Epidemiologic studies show that exposure to high levels of road traffic noise for several years lead to numerous adverse health outcomes, including premature deaths, ischemic heart disease (IHD), chronic sleep disturbances, and increased annoyance. Mechanistically, noise exposure triggers oxidative stress, inflammation, endothelial dysfunction, and circadian rhythm disruptions. These processes involve the activation of NADPH oxidase, mitochondrial dysfunction, and nitric oxide synthase uncoupling, leading to vascular and cardiac damage. Studies indicate that chronic noise exposure does not result in habituation, and susceptible individuals, such as those with pre-existing CVD, are particularly vulnerable.