A Global Analysis of Associations between Fine Particle Air Pollution and Cardiovascular Risk Factors: Feasibility
Min Zhao1, Gerard Hoek2, Maciej Strak2
1Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, NL.
Background:
This paper presents a feasibility study of data linkage between global air pollution data and clinical medical data to assess the associations of PM2.5 with cardiovascular risk factors.
Methods:
Cardiovascular risk factor data were obtained from the SUrvey of Risk Factors (SURF) for coronary heart disease (CHD) patients from 10 countries in Europe, Asia, and the Middle-East. Annual average PM2.5 concentrations were estimated using recent global WHO PM2.5 maps combining satellite and surface monitoring data for the location of the 71 participating centers. Associations of PM2.5 with risk factors were assessed by mixed-effect generalized estimation equation models adjusted by sex, age, exercise, body mass index, and smoking. In the final model there was further adjustment for country.
Results:
Linkage between cardiovascular risk factor data and PM2.5 via the postal address of participating hospitals was shown to be feasible, however with several limitations noted.Eight thousand three hundred and ninety two patients (30% women) were included. Globally, an increase of 10 μg/m3 in PM2.5 was significantly associated with decreased BP and increased glucose. After controlling for country, an increase of 10 μg/m3 in PM2.5 was associated with decreased BP and increased LDL (SBP: -0.45 mmHg [95% CI: -0.85, -0.06]; DBP: -0.47 mmHg [-0.73, -0.20]; LDL: 0.04 mmol/L [0.01, 0.08]). The association with glucose attenuated (0.08 mmol/L [-0.23, 0.16]).
Conclusion:
It is feasible to link PM2.5 and cardiovascular risk factors but it is still challenging to interpret these observed associations due to unavailability of potential confounders. After country adjustment, PM2.5 was associated with small increases in LDL and small decreases in BP.
Highlights:
- There are limited studies on the association between air pollution and cardiovascular risk factors for patients with established coronary heart disease in low- and middle-income countries;- Data linkage is an efficient and cost-effective method to maximize the use of existing data to investigate more health related research questions;- It is feasible to determine global associations of air pollution and cardiovascular risk factors by data linkage but it is still challenging in terms of interpretation.
More Related Videos
09:33Visualizing Field Data Collection Procedures of Exposure and Biomarker Assessments for the Household Air Pollution Intervention Network Trial in India
Published on: December 23, 2022
05:18Measuring Carbon Content in Airway Macrophages Exposed to Carbon-Containing Particulate Matters
Published on: July 12, 2024
Related Concept Videos
01:25Statistical Methods for Analyzing Epidemiological Data
01:11Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
01:28Criteria for Causality: Bradford Hill Criteria - II
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:26Introduction to Epidemiology