With reference to the EU-Council Directive (1999/30/EC) a discussion in the European Union between basic science, epidemiologic knowledge, and regulatory policies has become of growing public interest. The consequences following particulate matter (PM) exposure on the cardiovascular system, are actually not fully understood. This work reviews latest developments as regards the realization of the mentioned Council Directive and emphasizes the cardiovascular health impairment in this context. PM is assumed to increase the risk for arrhythmia, ischemic cardiovascular events, and worsens heart failure. The importance of the risk factor PM is due to the number of people who are affected, if consequent actions for air pollution prevention are not adequately transposed. Health-care providers can protect especially patients at high risk by informing them about behavior modification to prevent PM exposure and its possible consequences. To promote public health on the health-policy level, several action plans have been established. Forthcoming challenge for PM-associated cardiovascular health promotion remains an interdisciplinary approach to create synergistic effects of several sanctions, which primarily concerns scientific and political decision makers and public consciousness. In conclusion, further investigations are necessary to deepen the understanding of PM exposure and its consequences for the cardiovascular system and evaluate the success of preventive strategies.