Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China)
Background: Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is lacking. This study aimed to investigate the associations between long-term exposure to ambie...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Environment International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412023001022 |
| _version_ | 1797840040709062656 |
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| author | Yanjie Xia Zhiguang Liu Bo Hu Sumathy Rangarajan Lap Ah Tse Yang Li Junying Wang Lihua Hu Yang Wang Quanyong Xiang Yang Lin Guoliang Han Salim Yusuf Wei Li |
| author_facet | Yanjie Xia Zhiguang Liu Bo Hu Sumathy Rangarajan Lap Ah Tse Yang Li Junying Wang Lihua Hu Yang Wang Quanyong Xiang Yang Lin Guoliang Han Salim Yusuf Wei Li |
| author_sort | Yanjie Xia |
| collection | DOAJ |
| description | Background: Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is lacking. This study aimed to investigate the associations between long-term exposure to ambient fine particulate matter<2.5 µm (PM2.5) concentrations and the risk of incidence and mortality of CVD in a large cohort study from 115 communities. Methods: In this cohort study, we followed 42 160 adults aged 35–75 years at baseline who enrolled in the Prospective Urban and Rural Epidemiology Study conducted in China (PURE-China) between 2005 and 2009 with ambient PM2.5 estimates, and followed up until August 2021. Cox proportional hazards frailty models were used to estimate the associations between long-term mean outdoor PM2.5 concentrations and CVD events, CVD mortality, and all-cause mortality. Findings: During a median follow-up period of 11.8 years, we documented 2 190 deaths, including 732 CVD deaths. There were 4 559 (10.8 %) of 42 160 participants who experienced incident total CVD, among them there were 861 myocardial infarctions (MI) and 2 338 S. The 3-year median concentration of ambient PM2.5 before the cohort commencement was 52.7 µg/m3 (interquartile range [IQR] 30.3–74.6). In full adjusted model, a 10 µg/m3 increase in PM2.5 was associated with a hazard ratio (HR) of 1.12 (95 % CI 1.11–1.14) for major CVD and 1.03 (95 % CI 1.01–1.05) for all-cause mortality. Besides, long-term PM2.5 concentrations had a significantly positive gradient association with total CVD and a similar pattern of associations with other CVD outcomes was observed. Interpretation: This study demonstrated that long-term ambient PM2.5 concentrations is positively associated with increased risks of CVD in adults aged 35–70 years from China. This finding reinforces the need for policymakers to adopt more effective strategies to improve air quality. |
| first_indexed | 2024-04-09T16:08:00Z |
| format | Article |
| id | doaj.art-d858d555cb184492a62861687f3aa444 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-04-09T16:08:00Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-d858d555cb184492a62861687f3aa4442023-04-25T04:07:35ZengElsevierEnvironment International0160-41202023-04-01174107829Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China)Yanjie Xia0Zhiguang Liu1Bo Hu2Sumathy Rangarajan3Lap Ah Tse4Yang Li5Junying Wang6Lihua Hu7Yang Wang8Quanyong Xiang9Yang Lin10Guoliang Han11Salim Yusuf12Wei Li13Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaMedical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, CanadaDivision of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, ChinaMedical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBalingqiao Community Health Service Center, Xinghualing District, Taiyuan, Shanxi Province, ChinaNanchang County Center for Disease Control and Prevention, Nanchang, Jiangxi Province, ChinaMedical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaCenters for Disease Control and Prevention in Jiangsu Province, Nanjing, Jiangsu Province, ChinaDepartment of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaMedical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, CanadaMedical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Corresponding author.Background: Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is lacking. This study aimed to investigate the associations between long-term exposure to ambient fine particulate matter<2.5 µm (PM2.5) concentrations and the risk of incidence and mortality of CVD in a large cohort study from 115 communities. Methods: In this cohort study, we followed 42 160 adults aged 35–75 years at baseline who enrolled in the Prospective Urban and Rural Epidemiology Study conducted in China (PURE-China) between 2005 and 2009 with ambient PM2.5 estimates, and followed up until August 2021. Cox proportional hazards frailty models were used to estimate the associations between long-term mean outdoor PM2.5 concentrations and CVD events, CVD mortality, and all-cause mortality. Findings: During a median follow-up period of 11.8 years, we documented 2 190 deaths, including 732 CVD deaths. There were 4 559 (10.8 %) of 42 160 participants who experienced incident total CVD, among them there were 861 myocardial infarctions (MI) and 2 338 S. The 3-year median concentration of ambient PM2.5 before the cohort commencement was 52.7 µg/m3 (interquartile range [IQR] 30.3–74.6). In full adjusted model, a 10 µg/m3 increase in PM2.5 was associated with a hazard ratio (HR) of 1.12 (95 % CI 1.11–1.14) for major CVD and 1.03 (95 % CI 1.01–1.05) for all-cause mortality. Besides, long-term PM2.5 concentrations had a significantly positive gradient association with total CVD and a similar pattern of associations with other CVD outcomes was observed. Interpretation: This study demonstrated that long-term ambient PM2.5 concentrations is positively associated with increased risks of CVD in adults aged 35–70 years from China. This finding reinforces the need for policymakers to adopt more effective strategies to improve air quality.http://www.sciencedirect.com/science/article/pii/S0160412023001022Air pollutionLong-term exposurePM2.5CVDs |
| spellingShingle | Yanjie Xia Zhiguang Liu Bo Hu Sumathy Rangarajan Lap Ah Tse Yang Li Junying Wang Lihua Hu Yang Wang Quanyong Xiang Yang Lin Guoliang Han Salim Yusuf Wei Li Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) Environment International Air pollution Long-term exposure PM2.5 CVDs |
| title | Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) |
| title_full | Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) |
| title_fullStr | Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) |
| title_full_unstemmed | Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) |
| title_short | Associations of outdoor fine particulate air pollution and cardiovascular disease: Results from the Prospective Urban and Rural Epidemiology Study in China (PURE-China) |
| title_sort | associations of outdoor fine particulate air pollution and cardiovascular disease results from the prospective urban and rural epidemiology study in china pure china |
| topic | Air pollution Long-term exposure PM2.5 CVDs |
| url | http://www.sciencedirect.com/science/article/pii/S0160412023001022 |
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