WATCH: Roundtable Discussion Explores Impact of Environmental and Social Determinants on Heart Health

Researchers from the Houston Methodist DeBakey Heart and Vascular Center are stepping up efforts to understand how environmental factors and social determinants affect cardiovascular health, according to a recent roundtable discussion featuring a panel of leading experts in the field.

Dr. William Zoghbi, chief of Cardiology at Houston Methodist, moderates the conversation, an enlightening exploration of the hospital's commitment to this critical yet underdiscussed area of research.

Panelists include Dr. Khurram Nasir, a prolific principal investigator and chief of Cardiovascular Prevention and Wellness at Houston Methodist; Dr. Eleanora Avenatti, an obesity and cardiometabolic health expert; and Dr. Sadeer Al-Kindi, medical director of the Center for Health and Nature at Houston Methodist and an emerging national authority on environmental health.

Dr. Al-Kindi discusses the concept of the exposome, describing it as a cumulative measure of environmental exposures from conception onward, encompassing pollutants such as air toxins, water contamination, noise and even light pollution. He emphasizes that environmental factors significantly impact cardiovascular health — possibly even more than genetics and traditional heart-related risk factors — including increasing the risks of hypertension, insulin resistance, obesity and inflammation.

Panelists share evidence demonstrating that air pollution, traditionally viewed primarily as a respiratory threat, is increasingly linked to cardiovascular disease. Dr. Al-Kindi notes that clinical trials show air pollution elevates blood pressure and insulin resistance, accelerating conditions like heart disease and diabetes.

Dr. Nasir addresses social determinants of health, including socioeconomic status, neighborhood safety, education, transportation and access to health care. He stresses that low-income populations often experience higher cardiometabolic risks due to increased exposure to adverse environments, including food deserts and unsafe neighborhoods, compounding existing disparities.

Dr. Avenatti highlights the role of systemic biases, advocating for increased education and awareness among all health care professionals. She emphasizes that clinical bias and inadequate support structures often exacerbate health inequities, particularly in obesity management. The panel calls for a shift in clinical practice to acknowledge these determinants actively.

The researchers discuss practical measures clinicians can adopt immediately, including integrating social determinants into patient evaluations, promoting unbiased health care interactions, and using affordable treatments to mitigate environmental impacts. They also suggest community-driven interventions, like peer-support programs and local partnerships, to increase patient trust and treatment efficacy.

The panelists conclude by urging colleagues to join their efforts to drive momentum for broader, data-driven approaches involving community and patient advocacy groups in addressing cardiovascular disparities caused by environmental and social determinants of health.