The relationship between noise pollution and cardiovascular diseases: an umbrella review on meta-analyses

Abstract

Cardiovascular disease (CVD) is a global health concern, with established risk factors like smoking, hypertension (HTN), diabetes, and dyslipidemia. Emerging evidence suggests that environmental noise resulting from urbanization and industrialization may contribute to CVD. A comprehensive assessment of existing research is needed to understand the role of environmental noise in cardiovascular health. Following PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, and Web of Science from inception to 8 May 2025, identifying relevant meta-analyses with specific inclusion and exclusion criteria. Data extraction encompassed study characteristics, exposure-outcome details, and effect estimates. Methodological quality was assessed using the GRADE framework. In our umbrella review of 20 studies, we found that noise pollution is associated with an increased risk of HTN (RR 1.81, 95% CI: 1.51–2.18), atrial fibrillation (RR 1.05, 95% CI: 1.02–1.09), coronary heart disease (RR 1.08, 95% CI: 1.04–1.13), and ischemic heart disease (RR 1.06, 95% CI: 1.03–1.09) per 10-decibel (dB) increase in noise exposure. The exposure-response relationship indicated effects at lower noise levels (50 dB). However, noise exposure did not significantly impact myocardial infarctions (RR 1.02, 95% CI: 1.00–1.05), ischemic heart disease mortality (RR 1.03, 95% CI: 0.99–1.08), or cardiovascular mortality (RR 1.01, 95% CI: 0.98–1.05). We also observed an elevated risk of stroke (RR 1.04, 95% CI: 1.00–1.08) and stroke mortality (RR 1.05, 95% CI: 0.97–1.14). Blood pressure dysregulations (RR 2.55, 95% CI: 1.94–3.36) and ECG abnormalities (RR 2.27, 95% CI: 1.96–2.62) were substantially higher in individuals exposed to noise. Our umbrella review strongly suggests noise exposure as a significant potential risk factor for CVD. The substantial evidence and consistent effect sizes found in our analysis underscore the crucial importance of recognizing noise pollution as a substantial contributor to CVD. With urbanization and industrialization driving increased noise levels, understanding this link is of paramount importance for public health and future research.