Because so many people are exposed to dirty air, air pollution while stuck in traffic topped the list of potential heart attack triggers, with the researchers pegging 7.4 percent of heart attacks to roadway smog.
But coffee was also linked to five percent of attacks, booze to another five percent, and pot smoking to just under one percent, the European researchers found.
Among everyday activities, exerting yourself physically was linked to 6.2 percent of heart attacks, indulging in a heavy meal was estimated to trigger 2.7 percent, and sex was linked to 2.2 percent.
The report was published in the February 24 online edition of The Lancet.
The researchers stressed that the risk for heart attack from any one of these factors to a particular person at any given time is extremely small. But spread out over the population, they can add up.
For example, air pollution is a minor trigger for heart attacks, but since so many people are exposed to smog, it triggers many more heart attacks than other more potent triggers, such as alcohol and cocaine.
Lead researcher and assistant professor of epidemiology at the Hasselt Centre for Environmental Sciences at Hasselt University in Diepenbeek, Belgium, Tim S. Nawrot, explained: “Small risks can be highly relevant if they are widely distributed in the population.”
In their research, Nawrot’s team looked at 36 studies examining environmental triggers for heart attacks. In their review, known as a meta-analysis, the researchers looked for common threads that could establish how these factors might rank in risk.
In terms of risk, the team found that air pollution increased a person’s risk of having a heart attack by just under five percent. In contrast, coffee increased the risk by 1.5 times, alcohol tripled the risk, and cocaine use increased the odds for heart attack 23-fold.
However, because only a small number of people in the entire population are exposed to cocaine, while hundreds of millions are exposed to air pollution daily, air pollution was estimated to cause more heart attacks across the population than cocaine.
Even emotional states can sometimes trigger a heart attack, the team found. For example, negative emotions in general were linked to almost four percent of heart attacks while anger, specifically, was linked to just over three percent. Even “good” emotional states were tied to 2.4 percent of heart attacks, the study authors noted.
Although exposure to secondhand smoke was not included in the analysis, the effects are probably of the same magnitude as air pollution, the authors added. Where bans on smoking in public places exist, the rate of heart attacks has dropped an average of 17 percent, they noted.
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