Transportation Noise and Cardiovascular Health: Evidence, Mechanisms, and Policy Imperatives.

Environmental noise, particularly from road, rail, and aircraft traffic, is now firmly recognized as a widespread risk factor for cardiovascular disease. About 1 in 3 Europeans is exposed to chronic noise exposure above the guideline thresholds recommended by the World Health Organization (WHO), thus contributing substantially to cardiovascular morbidity and mortality. Robust evidence from recent meta-analyses links transportation noise to ischemic heart disease, heart failure, stroke, hypertension, and type 2 diabetes mellitus. Findings from experimental studies in both humans and animal models reveal biologically plausible mechanisms involving sympathetic nervous system activation, oxidative stress, inflammation, endothelial dysfunction, and disruption of circadian rhythms. The adverse health effects are particularly pronounced for nighttime noise, which disrupts restorative sleep and alters neurohormonal balance. Emerging research using the exposome framework highlights the cumulative toll of environmental stressors, including noise, on vulnerable populations. This review combines the latest evidence from epidemiology, mechanistic research, and intervention studies and outlines a road-map for incorporating noise into cardiovascular prevention strategies. Figures illustrate key concepts such as the noise reaction model, oxidative stress pathways, and practical mitigation measures. The conclusion calls for noise to be treated as a fully recognized cardiovascular risk factor-in parallel with traditional risks-and to address it through coordinated efforts in urban planning, public health policy, and clinical practice.