Telomere length and cardiovascular protection during chronic air pollution

Q: What are the key findings of this study?

High air pollution exposure combined with short telomere length was associated with higher carotid plaque prevalence vs low pollution and long telomeres (40.4% vs 17.9%, p<0.01).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Atherosclerotic burden and cardiovascular risk (n=418). Intervention: High air pollution exposure and short leukocyte telomere length vs. Low air pollution exposure and long leukocyte telomere length. Primary outcome: Atherosclerotic burden (carotid plaque prevalence, cfPWV, and cIMT) and leukocyte telomere length (p=<0.01).

Q: What does this research mean for the field?

Longer leukocyte telomere length attenuates the adverse vascular and atherosclerotic effects associated with chronic exposure to high air pollution. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate whether air pollution exposure correlates with shorter leukocyte telomere length and whether telomere length modifies the vascular impacts of chronic pollution.

M Sagris; S T Toupance; P T Theofilis; E O Oikonomou; N B Barbaresos; M.N Asimakopoulos; B C Clerc; C L Lakomy; G L Lazaros; K T Tsioufis; A B Benetos; D. Tousoulis

doi:10.1093/eurheartj/ehag785.3515

October 1, 2026European Heart JournalOpen Access

Telomere length and cardiovascular protection during chronic air pollution

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Key result

High air pollution plus short telomeres linked to ~2.3-fold higher carotid plaque prevalence.

P<0.01
n=418

Why the study?

Higher air pollution exposure and shorter leukocyte telomere length (LTL) are both associated with increased cardiovascular disease risk, but whether air pollution exposure is associated with shorter LTL and whether LTL modulates the cardiovascular effects of pollution exposure was uncertain.

Does high air pollution exposure and shorter leukocyte telomere length increase atherosclerotic burden (cfPWV, cIMT, and carotid plaque) in adults from the Corinthia region in Greece?

Key Points

To evaluate whether air pollution exposure correlates with shorter leukocyte telomere length and whether telomere length modifies the vascular impacts of chronic pollution.
Cross-sectional study of 418 participants (mean age 62.4 ± 11.8 years) from the Corinthia study in Greece, divided equally between high (HAPA) and low (LAPA) air pollution areas based on CO, NO2, and SO2 levels.
Leukocyte telomere length (LTL) was quantified by Southern blot, and vascular burden was evaluated via carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and carotid plaque presence.
Overall age- and sex-adjusted LTL did not differ significantly between HAPA and LAPA groups (p=0.42), but HAPA individuals exposed starting at age ≤20 years had significantly shorter LTL than those exposed later (B=-0.169, p=0.012).
Participants with both high pollution exposure and short LTL (Group 4) exhibited significantly higher cfPWV and cIMT than the other three groups (p<0.05).
Carotid plaque prevalence rose progressively from 17.9% in low pollution/long LTL to 22.5% in low pollution/short LTL, 29.7% in high pollution/long LTL, and 40.4% in high pollution/short LTL (p<0.01).

Study Design

Type

Cross-Sectional (n=418)

Structured PICO

Does high air pollution exposure and shorter leukocyte telomere length increase atherosclerotic burden (cfPWV, cIMT, and carotid plaque) in adults from the Corinthia region in Greece?

P

Population

418 individuals (mean age 62.4 years) from the Corinthia study in Greece living in either high or low air pollution areas.

E

Exposure

High air pollution area (HAPA) exposure and/or short leukocyte telomere length (LTL, cutoff at median 6.78 kb)

C

Comparator

Low air pollution area (LAPA) exposure and/or long leukocyte telomere length (LTL)

O

Outcome

Leukocyte telomere length (LTL) measured from whole blood by Southern blot, and atherosclerotic burden evaluated by carotid-femoral pulse wave velocity (cfPWV), carotid intima media thickness (cIMT), and presence of carotid plaquesurrogate

Main Result

Absolute Event Rate: 40.4% vs 17.9%

p-value: p=<0.01

Prolonged exposure to high air pollution starting early in life negatively impacts telomere length, while longer telomeres may partially protect against the adverse vascular effects (increased arterial stiffness, intima-media thickness, and carotid plaque) of chronic air pollution.

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Implication

Early air pollution exposure (≤20 years) was associated with shorter LTL and rising carotid plaque; hypothesis-generating for mediation in pollution-CVD links.

Abstract

Objective Higher air pollution exposure and shorter leukocyte telomere length (LTL) are both associated with increased risk of cardiovascular disease. In this study we examined whether air pollution exposure is associated with shorter LTL and whether LTL can modulate the effects of pollution exposure on cardiovascular state. Design and Method In this cross-sectional analysis we selected 418 individuals, aged 62.4 ± 11.8 years, from the "Corinthia" study which was conducted in the homonym region in Greece. Half of the participants lived in a high air pollution area (HAPA) according to the CO, NO2 and SO2levels and the other half in a low air pollution area (LAPA). LTL was measured from whole blood by Southern blot and carotid-femoral pulse wave velocity (cfPWV), carotid intima media thickness (cIMT) and presence of carotid plaque were determined to evaluate atherosclerotic burden. Results We found no difference in age and sex adjusted LTL between HAPA and LAPA groups (p=0.42). In multivariate analysis including age, sex, as co-factors, participants of HAPA whose exposure began at an earlier age (≤ 20 years) had significantly shorter LTL compared to those exposed at >20 years of age (B=-0.169, p=0.012). Using the median LTL (6.78 kb) as a cutoff, the cohort was divided into four groups: Group 1 - LAPA/Long LTL (108 subjects), Group 2 - LAPA/Short LTL (98 subjects), Group 3 - HAPA/ Long LTL (102 subjects), and Group 4 - HAPA/Short LTL (110 subjects). Group 4 patients had significantly greater cf-PWV and cIMT compared to the other three groups (p<0.05), whereas there was no intragroup difference between the other clusters. These differences subsisted after adjustment for age and sex. Carotid plaque prevalence increased from 17.9% for Group 1 to 22.5% for Group 2, 29.7% for Group 3 and 40.4% for Group 4 (p < 0.01). Conclusion Prolonged exposure to high air pollution starting early in life seems to display a negative effect on telomere dynamics. Presence of longer telomeres may at least partially protect from negative effects of high air pollution exposure on vascular health. These results could be used for personalized cardiovascular risk prevention.

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Cite This Study

Sagris et al. (2026) conducted a cross-sectional in Atherosclerotic burden and cardiovascular risk (n=418). High air pollution exposure and short leukocyte telomere length vs. Low air pollution exposure and long leukocyte telomere length was evaluated on Atherosclerotic burden (carotid plaque prevalence, cfPWV, and cIMT) and leukocyte telomere length (p=<0.01). High air pollution exposure combined with short telomere length was associated with higher carotid plaque prevalence vs low pollution and long telomeres (40.4% vs 17.9%, p<0.01).

synapsesocial.com/papers/6ae13d36043bfbd635332996 https://doi.org/10.1093/eurheartj/ehag785.3515

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Telomere length and cardiovascular protection during chronic air pollution

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Telomere length and cardiovascular protection during chronic air pollution

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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