Long-term exposure to air pollutants and cardiovascular disease endpoints in adults

摘要

Background. There are only few studies which investigated the association between residential long-term exposure to air pollutants and cardiovascular disease endpoints. Aims. As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) project this work package aimed to quantify the effects of long-term exposures to ambient air pollution on intermediate phenotypes of cardiovascular disease, and on the incidence of coronary artery disease and cerebrovascular disease in differently exposed populations in Europe. Specifically, we evaluated the impact of ambient air pollution on markers of inflammation (aim1), on blood pressure and prevalence of hypertension (aim2), on the risk for build-up of preclinical atherosclerosis measured by intima-media thickness (IMT) of the carotid artery (aim3), and on incident coronary events and stroke (aim4). Methods. All cohorts assessed the spatial variability of residential long-term exposure to particulate matter and nitrogen oxide using land-use regression models. Cohort-specific effect estimates were calculated and subsequently pooled using meta-analysis. Endpoint-specific confounders and effect-modifiers were considered. Results. Seven cohorts contributed to aiml with 22,561 participants, 12 cohorts to aim2 with 98,448 participants, 4 cohorts to aim3 with 9,331 participants, and 11 cohorts to aim4 with 100,166 participants. Levels of C-reactive protein were associated with traffic exposures and nitrogen oxides. Blood pressure and hypertension were associated with traffic counts. IMT showed associations with traffic in two of the four cohorts, but not on a meta-analytical level. In contrast, the risk of coronary events was related to long-term exposure to inhalable particulate matter. Conclusions/The findings substantiate the link between long-term exposure and ischemic heart disease and indicate that chronic subclinical inflammation may contribute to these associations.