Acute exposure to air pollution is associated with an increasing risk of death and cardiovascular disorders. Nonetheless, the impact of chronic exposure to air pollution on the circulatory system is still debated. Here, we review the links of chronic exposure to outdoor air pollution with mortality and most common cardiovascular diseases, in particular during the coronavirus disease 2019 event (COVID-19). We found that recent studies provide robust evidence for a causal effect of chronic exposure to air pollution and cardiovascular mortality. In terms of mortality, the strongest relationship was noted for fine particulate matter, nitrogen dioxide, and ozone. There is also increasing evidence showing that exposure to air pollution, mainly fine particulate matter and nitrogen dioxide, is associated with the development of atherosclerosis, hypertension, stroke, and heart failure. However, available scientific evidence is not strong enough to support associations with cardiac arrhythmias and coagulation disturbances. Noteworthy, for some pollutants, the risk of negative health effects is high for concentrations lower than the limit values recommended by the European Union and Word Health Organization. Efforts to diminish exposure to air pollution and to design optimal methods of air pollution reduction should be urgently intensified and supported by effective legislation and interdisciplinary cooperation.

急性暴露于空气污染与死亡和心血管疾病的风险增加有关。尽管如此，长期暴露于空气污染对循环系统的影响仍然存在争议。在这里，我们回顾了长期暴露于室外空气污染与死亡率和最常见心血管疾病之间的联系，特别是在 2019 年冠状病毒病事件 (COVID-19) 期间。我们发现，最近的研究为长期暴露于空气污染和心血管死亡率的因果关系提供了强有力的证据。在死亡率方面，细颗粒物、二氧化氮和臭氧的相关性最强。还有越来越多的证据表明，暴露于空气污染（主要是细颗粒物和二氧化氮）与动脉粥样硬化的发展有关，高血压、中风和心力衰竭。然而，现有的科学证据不足以支持与心律失常和凝血障碍的关联。值得注意的是，对于某些污染物，如果浓度低于欧盟和世界卫生组织推荐的限值，则对健康产生负面影响的风险很高。应紧急加强减少空气污染暴露和设计减少空气污染的最佳方法的努力，并得到有效立法和跨学科合作的支持。浓度低于欧盟和世界卫生组织推荐的限值时，对健康产生负面影响的风险很高。应紧急加强减少空气污染暴露和设计减少空气污染的最佳方法的努力，并得到有效立法和跨学科合作的支持。浓度低于欧盟和世界卫生组织推荐的限值时，对健康产生负面影响的风险很高。应紧急加强减少空气污染暴露和设计减少空气污染的最佳方法的努力，并得到有效立法和跨学科合作的支持。