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Long-term air pollution exposure and cardiovascular disease risk across cardiovascular-renal-metabolic stages: a nationwide study

BMC Public Health · last updated
  1. Li Y, Cao G, Jing W, Liu J, Liu M. Global trends and regional differences in incidence and mortality of cardiovascular disease, 1990– 2019: findings from 2019 global burden of disease study. Eur J Prev Cardiol. 2023;30:276–86.

    Article  PubMed  Google Scholar 

  2. Brauer M, Casadei B, Harrington RA, Kovacs R, Sliwa K, the WHF Air Pollution Expert Group. Taking a stand against air pollution – the impact on cardiovascular disease: A joint opinion from the world heart federation, American college of cardiology, American heart association, and the European society of cardiology. Eur Heart J. 2021;42:1460–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lelieveld J, Haines A, Burnett R, Tonne C, Klingmüller K, Münzel T, et al. Air pollution deaths attributable to fossil fuels: observational and modelling study. BMJ. 2023;383:e077784.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Yang B-Y, Guo Y, Morawska L, Bloom MS, Markevych I, Heinrich J, et al. Ambient PM1 air pollution and cardiovascular disease prevalence: insights from the 33 communities Chinese health study. Environ Int. 2019;123:310–7.

    Article  CAS  PubMed  Google Scholar 

  5. Chen J, Hoek G. Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis. Environ Int. 2020;143:105974.

    Article  CAS  PubMed  Google Scholar 

  6. Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, et al. A synopsis of the evidence for the science and clinical management of Cardiovascular-Kidney-Metabolic (CKM) syndrome: A scientific statement from the American heart association. Circulation. 2023. https://doi.org/10.1161/CIR.0000000000001186

    Article  PubMed  PubMed Central  Google Scholar 

  7. Marchini T. Redox and inflammatory mechanisms linking air pollution particulate matter with cardiometabolic derangements. Free Radic Biol Med. 2023;209:320–41.

    Article  CAS  PubMed  Google Scholar 

  8. Koenen M, Hill MA, Cohen P, Sowers JR. Obesity, adipose tissue and vascular dysfunction. Circ Res. 2021;128:951–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Brook RD, Motairek I, Rajagopalan S, Al-Kindi S. Excess global blood pressure associated with fine particulate matter air pollution levels exceeding world health organization guidelines. J Am Heart Assoc. 2023;12:e029206.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Paul LA, Burnett RT, Kwong JC, Hystad P, Van Donkelaar A, Bai L, et al. The impact of air pollution on the incidence of diabetes and survival among prevalent diabetes cases. Environ Int. 2020;134:105333.

    Article  CAS  PubMed  Google Scholar 

  11. Li F-R, Zhu B, Liao J, Cheng Z, Jin C, Mo C, et al. Ambient air pollutants and incident microvascular disease: A cohort study. Environ Sci Technol. 2022;56:8485–95.

    Article  CAS  PubMed  Google Scholar 

  12. Vieira de Oliveira Salerno PR, Cotton A, Elgudin YE, Virani S, Nasir K, Neeland I, et al. Social and environmental determinants of health and Cardio-Kidney-Metabolic Syndrome-Related mortality. JAMA Netw Open. 2024;7:e2435783.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G. Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol. 2014;43:61–8.

    Article  PubMed  Google Scholar 

  14. Wei J, Li Z, Xue W, Sun L, Fan T, Liu L, et al. The ChinaHighPM10 dataset: generation, validation, and Spatiotemporal variations from 2015 to 2019 across China. Environ Int. 2021;146:106290.

    Article  CAS  PubMed  Google Scholar 

  15. Wei J, Li Z, Guo J, Sun L, Huang W, Xue W, et al. Satellite-Derived 1-km-Resolution PM1 concentrations from 2014 to 2018 across China. Environ Sci Technol. 2019;53:13265–74.

    Article  PubMed  Google Scholar 

  16. Wei J, Li Z, Cribb M, Huang W, Xue W, Sun L, et al. Improved 1 Km resolution PM2.5 estimates across China using enhanced space–time extremely randomized trees. Atmos Chem Phys. 2020;20:3273–89.

    Article  CAS  Google Scholar 

  17. Wei J, Li Z, Lyapustin A, Sun L, Peng Y, Xue W, et al. Reconstructing 1-km-resolution high-quality PM2.5 data records from 2000 to 2018 in china: Spatiotemporal variations and policy implications. Remote Sens Environ. 2021;252:112136.

    Article  Google Scholar 

  18. Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, et al. Cardiovascular-Kidney-Metabolic health: A presidential advisory from the American heart association. Circulation. 2023;148:1606–35.

    Article  PubMed  Google Scholar 

  19. Yang X, Li J, Hu D, Chen J, Li Y, Huang J, et al. Predicting the 10-Year risks of atherosclerotic cardiovascular disease in Chinese population. Circulation. 2016;134:1430–40.

    Article  PubMed  Google Scholar 

  20. Ma Y-C, Zuo L, Chen J-H, Luo Q, Yu X-Q, Li Y, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006;17:2937–44.

    Article  PubMed  Google Scholar 

  21. Cui C, Liu L, zhang T, Fang L, Mo Z, Qi Y, et al. Triglyceride-glucose index, renal function and cardiovascular disease: a National cohort study. Cardiovasc Diabetol. 2023;22:325.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Yang B-Y, Guo Y, Markevych I, Qian Z (Min), Bloom MS, Heinrich J Association of Long-term Exposure to Ambient Air Pollutants With Risk Factors for Cardiovascular Disease in China, et al. editors. JAMA Network Open. 2019;2:e190318.

  23. Yan R, Hu Y, Yang J, Wang H, Wang Y, Song G. Depressive symptoms trajectories and cardiovascular disease in Chinese middle-aged and older adults: A longitudinal cohort study. J Affect Disord. 2025;380:456–65.

    Article  PubMed  Google Scholar 

  24. Li R, Lu Q, Chen J-X, Li R-Y, Li L, Ou Y-J, et al. Combined exposure to multiple air pollutants and incident ischemic heart disease in individuals with and without type 2 diabetes: A cohort study from the UK biobank. Diabetes Res Clin Pract. 2023;206:111019.

    Article  CAS  PubMed  Google Scholar 

  25. Miettinen OS, PROPORTION OF DISEASE CAUSED OR PREVENTED BY A GIVEN EXPOSURE, TRAIT OR INTERVENTION1. Am J Epidemiol. 1974;99:325–32.

    Article  CAS  PubMed  Google Scholar 

  26. Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, et al. A synopsis of the evidence for the science and clinical management of Cardiovascular-Kidney-Metabolic (CKM) syndrome: A scientific statement from the American heart association. Circulation. 2023;148:1636–64.

    Article  PubMed  Google Scholar 

  27. Claudel SE, Verma A. Cardiovascular-kidney-metabolic syndrome: A step toward multidisciplinary and inclusive care. Cell Metabol. 2023;35:2104–6.

    Article  CAS  Google Scholar 

  28. Hu X, Knibbs LD, Zhou Y, Ou Y, Dong G-H, Dong H. The role of lifestyle in the association between long-term ambient air pollution exposure and cardiovascular disease: a National cohort study in China. BMC Med. 2024;22:93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Liu X, Tu R, Qiao D, Niu M, Li R, Mao Z, et al. Association between long-term exposure to ambient air pollution and obesity in a Chinese rural population: the Henan rural cohort study. Environ Pollut. 2020;260:114077.

    Article  CAS  PubMed  Google Scholar 

  30. Li W, Shen C, Kong W, Zhou X, Fan H, Zhang Y, et al. Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0–3: a nationwide prospective cohort study. Cardiovasc Diabetol. 2024;23:292.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Li X, Wang M, Song Y, Ma H, Zhou T, Liang Z, et al. Obesity and the relation between joint exposure to ambient air pollutants and incident type 2 diabetes: A cohort study in UK biobank. PLoS Med. 2021;18:e1003767.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Kadelbach P, Weinmayr G, Chen J, Jaensch A, Rodopoulou S, Strak M, et al. Long-term exposure to air pollution and chronic kidney disease-associated mortality–Results from the pooled cohort of the European multicentre ELAPSE-study. Environ Res. 2024;252:118942.

    Article  CAS  PubMed  Google Scholar 

  33. Rajagopalan S, Al-Kindi SG, Brook RD. Air pollution and cardiovascular disease. J Am Coll Cardiol. 2018;72:2054–70.

    Article  CAS  PubMed  Google Scholar 

  34. Nichols GA, Amitay EL, Chatterjee S, Steubl D. The bidirectional association of chronic kidney disease, type 2 diabetes, atherosclerotic cardiovascular disease, and heart failure: the Cardio–Renal–Metabolic syndrome. Metab Syndr Relat Disord. 2023;21:261–6.

    Article  PubMed  Google Scholar 

  35. Shi L, Rosenberg A, Wang Y, Liu P, Danesh Yazdi M, Réquia W, et al. Low-Concentration air pollution and mortality in American older adults: A National cohort analysis (2001–2017). Environ Sci Technol. 2022;56:7194–202.

    Article  CAS  PubMed  Google Scholar 

  36. Cao Y, Wang W, Xie S, Xu Y, Lin Z. Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a National prospective study. BMC Public Health. 2025;25:10.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Mozos I, Malainer C, Horbańczuk J, Gug C, Stoian D, Luca CT et al. Inflammatory markers for arterial stiffness in cardiovascular diseases. Front Immunol. 2017;8.

  38. Oishi Y, Manabe I. Organ system crosstalk in cardiometabolic disease in the age of Multimorbidity. Front Cardiovasc Med. 2020;7.

  39. Zhu R, Wang R, He J, Wang L, Chen H, Niu X, et al. Prevalence of Cardiovascular-Kidney-Metabolic syndrome stages by social determinants of health. JAMA Netw Open. 2024;7:e2445309.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Boing AF, deSouza P, Boing AC, Kim R, Subramanian SV. Air pollution, socioeconomic status, and Age-Specific mortality risk in the united States. JAMA Netw Open. 2022;5:e2213540.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Ghelfi E, Wellenius GA, Lawrence J, Millet E, Gonzalez-Flecha B. Cardiac oxidative stress and dysfunction by fine concentrated ambient particles (CAPs) are mediated by angiotensin-II. Inhal Toxicol. 2010;22:963–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Miller MR. The cardiovascular effects of air pollution: prevention and reversal by Pharmacological agents. Pharmacol Ther. 2022;232:107996.

    Article  CAS  PubMed  Google Scholar 

  43. Ostro B, Malig B, Broadwin R, Basu R, Gold EB, Bromberger JT, et al. Chronic PM2.5 exposure and inflammation: determining sensitive subgroups in mid-life women. Environ Res. 2014;132:168–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar