There is a correlation between air pollution and myocardial infarction, but its effect on heart failure is poorly understood. Anoop S V Shah et al from the University of Edinburgh, UK, conducted a systematic review and meta-analysis of previous studies to assess the relationship between air pollution and the rate of hospital admissions and mortality in decompensated heart failure. The results showed a strong correlation between air pollution and heart failure hospitalization and mortality rates. The findings were published online in the latest issue of The Lancet in July. Previous studies were searched through five databases to examine the association between gases such as carbon monoxide, sulfur dioxide, nitrogen dioxide and ozone, as well as air pollutants such as particulate matter (less than 2.5 μm in diameter [PM2.5] or less than 10 μm in diameter [PM10]), and the risk of heart failure hospitalization and heart failure mortality. A random-effects model was used to analyze the association between each pollutant and the overall risk of heart failure. A total of 1146 articles were searched, 195 of which were examined in depth, and 35 articles that met the inclusion criteria were analyzed. The results showed that the risk of hospitalization and death from heart failure was associated with increased concentrations of carbon monoxide, sulfur dioxide, and nitrous oxide gases, but not significantly with ozone concentrations. Increased concentrations of particulate matter PM2.5 and PM10 were also associated with the risk of heart failure hospitalization and mortality. The results also showed that the length of exposure to air pollution was strongly correlated with the risk of hospitalization and death due to heart failure. The longer the duration of exposure, the greater the effect of the persistent effects of PM2.5. Researchers estimate that an average reduction in PM2.5 of 3.9 μg/m3 in the United States would prevent 7,978 hospitalizations due to heart failure, saving more than$30 million annually. There is a strong link between air pollution and the risk of hospitalization and death from heart failure. Although more studies from developing countries are needed to confirm these findings, air pollution has become a global public health issue due to its impact on cardiovascular disease and the economic consequences of health problems, and should be addressed as a permanent goal of global health policy.