Abstract
AimsEpidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events. We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease.Methods60 Patients (50p 1–3 vessels disease; 10p with a high Framingham Score of 23 %) were exposed in random and blinded order to aircraft noise and no noise conditions. Noise was simulated in the patients’ bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (flow-mediated dilation of the brachial artery), questionnaires and blood sampling were performed on the morning after each study night.ResultsThe mean sound pressure levels L eq(3) measured were 46.9 ± 2.0 dB(A) in the Noise 60 nights and 39.2 ± 3.1 dB(A) in the control nights. Subjective sleep quality was markedly reduced by noise from 5.8 ± 2.0 to 3.7 ± 2.2 (p < 0.001). FMD was significantly reduced (from 9.6 ± 4.3 to 7.9 ± 3.7 %; p < 0.001) and systolic blood pressure was increased (from 129.5 ± 16.5 to 133.6 ± 17.9 mmHg; p = 0.030) by noise. The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity.ConclusionsNighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.
Highlights
The role of noise as an environmental pollutant affecting health has been increasingly recognized
Polygraphy was recorded during study nights, endothelial function, questionnaires and blood sampling were performed on the morning after each study night
Nighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise
Summary
The role of noise as an environmental pollutant affecting health has been increasingly recognized. A recent investigator-blinded field study (The FLIGHTStudy) from our group demonstrated that simulated nighttime aircraft noise leads to endothelial dysfunction, worsening of sleep quality and increased vascular stiffness but no significant changes in blood pressure in young healthy volunteers [6]. In an accompanying editorial Charakido and Deanfield emphasized that when considering the relevance of the findings for long-term clinical outcomes as well as for the causal pathways to cardiovascular disease and complications, that it would be highly important to examine the effects of noise on endothelial function of patients with already established cardiovascular disease [7]. The FLIGHT-RISK study was set out to test the effect of nocturnal aircraft noise on endothelial function, stress hormone levels, blood pressure and inflammatory markers, sleeping quality, annoyance levels and coagulation markers in patients with established coronary artery disease or at high risk for developing coronary artery disease based on the Framingham score
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