Air pollution has been associated with increases in hospital admissions for cardiovascular diseases. This article aims to identify subgroups of individuals who exhibit early biological responses consistent with the health effects of ambient air pollution. Resting heart rates have been recorded in a cohort of 2681 men and women aged 25-64 yr who participated in the MONICA Augsburg survey during the winter 1984/1985 and in a reexamination during the winter 1987/1988. Increases in heart rate of 1.8 beats per minute (bpm) (95% confidence interval: 0.7 to 2.8 bpm) were observed during the air pollution episode compared to nonepisode days, adjusted for potential cardiovascular risk factors and meteorological parameters. Among persons whose plasma viscosity was above the 90th percentile, heart rates increased 5.1 bpm (95% confidence interval: 2.1 to 8.2 bpm) during the air pollution episode. Persons with normal values of plasma viscosity only had an increase of 1.4 bpm (95% confidence interval: 0.3 to 2.5 bpm) during the air pollution episode. Subjects with increased plasma viscosity showed a more pronounced acceleration in heart rate at rest, pointing toward a modification of the autonomic control of the heart during an air pollution episode.
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