Utahns with heart disease are especially vulnerable to the impacts of air pollution, a new study has found.

Heart researchers at Intermountain Health found that people with heart disease, especially those with heart failure, had higher inflammation biomarkers in their blood during short-term levels of air pollution from winter inversions and wildfire smoke.

“These biomarkers rose in response to air pollution in people who already had heart disease, but not in patients who were heart-disease-free,” said Benjamin Horne, principal investigator of the study and professor of research at Intermountain Health, during a press conference Dec. 2. “We drew the blood when the air pollution was above 20 micrograms per cubic meters, which, when you look at the air index, it falls into the middle of the yellow range.”

While previous research has shown people with certain chronic health conditions such as heart failure, coronary disease, asthma and chronic obstructive pulmonary disease, or COPD, struggle during times when air pollution spikes, the latest study shows that cardiac inflammation levels, specifically, rise in people with heart disease during periods of poor air quality.

For the study, researchers looked at blood tests for 115 different proteins that indicate increased inflammation in the body. A total of 44 patients with heart failure and 35 without participated in the study. Some of the blood was drawn on days with low air pollution, then compared the test results to blood draws when air pollution spiked.

The research found two inflammatory markers, CC27 (C-C motif chemokine ligand 27) and IL-18 (interleukin 18), increased in heart failure patients exposed to poor air quality.

“The people who were heart-disease-free showed no difference in the biomarkers,” Horne said. “Those individuals with heart disease had increased biomarkers and more problems during times of poor air quality, and they come to the hospital and are even admitted more frequently following the days when short-term air pollution increases because they are not (as) capable of responding to acute inflammation as people who are healthy. It’s an interesting mechanistic biological finding.”

Horne said it’s important that people with heart disease take protective precautions during times when the air pollution is bad.

“We could use this as a little nudge to make sure they’re taking their medication as prescribed,” he said “Also, don’t exercise outdoors. In general, just try to stay out of the outdoors. If you have to go out, go in the early morning before everyone is rushing to work and the traffic is higher, which means more pollution.”

Horne said during winter months, when air pollution is trapped when warm air holds pollution closer to the ground, people can go to higher elevations. He also suggested purchasing a high-efficiency particulate air, or HEPA, filter if you can afford the cost.

For the retrospective study, Intermountain Health researchers worked with scientists at Stanford University and the Harvard School of Public Health to examine the blood of patients enrolled in the Intermountain INSPIRE registry, which collects blood and other biological samples, medical information and laboratory data from healthy individuals and those who have been diagnosed with a variety of medical conditions.

Results of the study were presented at the American Heart Association’s national Scientific Session international conference.