Fengchao Liang1, Fangchao Liu1, Keyong Huang2, Xueli Yang2, Jianxin Li2, Qingyang Xiao3, Jichun Chen2, Xiaoqing Liu4, Jie Cao2, Chong Shen5, Ling Yu6, Fanghong Lu7, Xianping Wu8, Xigui Wu2, Ying Li2, Dongsheng Hu9, Jianfeng Huang2, Yang Liu10, Xiangfeng Lu2, Dongfeng Gu11. 1. Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. School of Environment, Tsinghua University, Beijing, China. 4. Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China. 5. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. 6. Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China. 7. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China. 8. Sichuan Center for Disease Control and Prevention, Chengdu, China. 9. Department of Prevention Medicine, Shenzhen University School of Medicine, Shenzhen, China. 10. Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia. 11. Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Medical School, Southern University of Science and Technology, Shenzhen, China. Electronic address: gudongfeng@cashq.ac.cn.
Abstract
BACKGROUND: Evidence of the effects of long-term fine particulate matter (PM2.5) exposure on cardiovascular diseases (CVDs) is rare for populations exposed to high levels of PM2.5 in China and in other countries with similarly high levels. OBJECTIVES: The aim of this study was to assess the CVD risks associated with long-term exposure to PM2.5 in China. METHODS: A nationwide cohort study, China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China), was used, with 116,972 adults without CVD in 2000 being included. Participants were followed until 2015. Satellite-based PM2.5 concentrations at 1-km spatial resolution during the study period were used for exposure assessment. A Cox proportional hazards model with time-varying exposures was used to estimate the CVD risks associated with PM2.5 exposure, adjusting for individual risk factors. RESULTS: Annual mean concentrations of PM2.5 at the China-PAR sites ranged from 25.5 to 114.0 μg/m3. For each 10 μg/m3 increase in PM2.5 exposures, the multivariate-adjusted hazard ratio was 1.251 (95% confidence interval: 1.220 to 1.283) for CVD incidence and 1.164 (95% confidence interval: 1.117 to 1.213) for CVD mortality. The slopes of concentration-response functions of PM2.5 exposure and CVD risks were steeper at high PM2.5 levels. In addition, older residents, rural residents, and never smokers were more prone to adverse effects of PM2.5 exposure. CONCLUSIONS: This study provides evidence that elevated long-term PM2.5 exposures lead to increased CVD risk in China. The effects are more pronounced at higher PM2.5 levels. These findings expand the current knowledge on adverse health effects of severe air pollution and highlight the potential cardiovascular benefits of air quality improvement in China and other low- and middle-income countries.
BACKGROUND: Evidence of the effects of long-term fine particulate matter (PM2.5) exposure on cardiovascular diseases (CVDs) is rare for populations exposed to high levels of PM2.5 in China and in other countries with similarly high levels. OBJECTIVES: The aim of this study was to assess the CVD risks associated with long-term exposure to PM2.5 in China. METHODS: A nationwide cohort study, China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China), was used, with 116,972 adults without CVD in 2000 being included. Participants were followed until 2015. Satellite-based PM2.5 concentrations at 1-km spatial resolution during the study period were used for exposure assessment. A Cox proportional hazards model with time-varying exposures was used to estimate the CVD risks associated with PM2.5 exposure, adjusting for individual risk factors. RESULTS: Annual mean concentrations of PM2.5 at the China-PAR sites ranged from 25.5 to 114.0 μg/m3. For each 10 μg/m3 increase in PM2.5 exposures, the multivariate-adjusted hazard ratio was 1.251 (95% confidence interval: 1.220 to 1.283) for CVD incidence and 1.164 (95% confidence interval: 1.117 to 1.213) for CVD mortality. The slopes of concentration-response functions of PM2.5 exposure and CVD risks were steeper at high PM2.5 levels. In addition, older residents, rural residents, and never smokers were more prone to adverse effects of PM2.5 exposure. CONCLUSIONS: This study provides evidence that elevated long-term PM2.5 exposures lead to increased CVD risk in China. The effects are more pronounced at higher PM2.5 levels. These findings expand the current knowledge on adverse health effects of severe air pollution and highlight the potential cardiovascular benefits of air quality improvement in China and other low- and middle-income countries.
Authors: Seulkee Heo; Ji-Young Son; Chris C Lim; Kelvin C Fong; Hayon Michelle Choi; Raul U Hernandez-Ramirez; Kate Nyhan; Preet K Dhillon; Suhela Kapoor; Dorairaj Prabhakaran; Donna Spiegelman; Michelle L Bell Journal: Environ Res Lett Date: 2022-05-16 Impact factor: 6.947
Authors: Omar Al-Mukhtar; Sara Vogrin; Edwin R Lampugnani; Samer Noaman; Diem T Dinh; Angela L Brennan; Christopher Reid; Jeffrey Lefkovits; Nicholas Cox; Dion Stub; William Chan Journal: J Am Heart Assoc Date: 2022-03-15 Impact factor: 6.106