Long-term exposure to ambient air pollution is associated with coronary artery calcification among asymptomatic adults

Abstract

Aims We investigated the effects of exposure to very low levels of particulate matter <2.5 µm (PM2.5) and nitrogen dioxide (NO2) on coronary calcium score (CCS) in asymptomatic adults who are free of coronary artery disease (CAD). Methods and results This study included 606 asymptomatic adults (49% men, aged 56±7 years) recruited from communities in three states of Australia during 2017–2018. CCS was measured using coronary computed tomography scan at recruitment. Annual PM2.5 and NO2 concentrations were estimated on the year before recruitment using statistical exposure models and assigned to each participant’s residential address. Medical history, physical measurements, biochemistry, and sociodemographic and socioeconomic status were also recorded. Median concentrations of PM2.5 and NO2 were 6.9 µg/m3 [interquartile range (IQR) 6.0–7.7)] and 3.1 ppb [IQR 2.2–4.5], respectively. Of the 606 participants, 16% had high CCS (≥100) and 4% had very high CCS (≥400). Exposure to higher PM2.5 (per µg/m3) was significantly associated with greater odds of having high CCS (OR 1.20, 95% CI 1.02–1.43) and very high CCS (OR 1.55, 95% CI 1.05–2.29). Similar associations were observed for NO2 and high CCS (OR 1.14, 95% CI 1.02–1.27) and very high CCS (OR 1.23, 95% CI 1.07–1.51). These findings were robust to adjustment for sociodemographic factors, traditional cardiovascular risk factors, renal function, education, and socio-economic status. Conclusions Ambient air pollution even at low concentration was associated with degree of coronary artery calcification among asymptomatic low cardiovascular risk adults, independent of other risk factors. These findings suggest that air pollution is one of the residual risk factors of CAD.

Air pollution and recurrence of cardiovascular events after ST-segment elevation myocardial infarction

“…In addition, we speculated that the air quality in Beijing had been improving year by year, leading to special and different risk trends. Previous studies have made few findings because their pollutant concentrations are relatively low and very stable over the years, and consider that differences in pollutant concentrations are mainly caused by spatial variation rather than temporal variation, but this assumption may be invalid in rapidly developing cities or countries [33,34].…”

Progress in research on effect of PM2.5 on occurrence and development of atherosclerosis

“…Most studies have published a significant correlation between PM 2.5 and AS. There has been a notable increase in studies assessing the health effects of extremely high to low PM 2.5 concentrations, which suggests adverse health effects due to PM 2.5 exposure, even at levels below WHO recommended standards (Wang, Zheng, et al, 2019; Yang et al, 2019; Huynh et al, 2020). There is a dose‐effect relationship between the PM 2.5 concentration and the ability to produce an inflammatory response and oxidative stress, which is positively correlated with the morbidity and mortality of CVDs (Zeka, Sullivan, Vokonas, Sparrow, & Schwartz, 2006).…”

“…Two other Canadian studies also demonstrated that long‐term exposure is capable of increasing the risk of cardiovascular events even at low exposure levels of 6.3 μg/m 3 (Pinault et al, 2016) and 5.9 μg/m 3 (Christidis et al, 2019). PM 2.5 even at low concentrations (6.9 μg/m 3 ) was associated with the development of AS among asymptomatic low cardiovascular risk adults, independent of other risk factors (Huynh et al, 2020). Although PM 2.5 levels at the threshold thought to be safe (within annual WHO AQG < 10 μg/m 3 ) may still promote the occurrence and development of AS.…”

Effect of probiotics on nasal and intestinal microbiota in people with high exposure to particulate matter ≤ 2.5 μm (PM2.5): a randomized, double-blind, placebo-controlled clinical study

“…The meta-analysis of global association of air pollution and heart failure indicated that air pollution especially the high concentration of PM2.5 has a close temporal association with heart failure hospitalization and heart failure mortality [12]. The studies also suggest that air pollution is one of the residual risk factors of CAD, and long-term exposure to fine particulate air pollution is associated with degree of coronary artery calcification, ischemic heart disease, and stroke mortality [13][14][15]. Another study shows that exposure to traffic air pollution may contribute to acute changes in blood pressure and autonomic and microvascular function in women [16].…”