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Updated: Jan 8, 2026
Aggravation of Myocardial Ischemia upon Particulate Matter Exposure in Atherosclerosis Animal Model
Published on: December 10, 2021
Long-term air pollution exposure and incident cardiovascular disease by multimorbidity status: a national cohort
Zhaofeng Jin1, Ying Luo1, Wenzhao Liu1
1Kweichow Moutai Hospital, Renhuai, Guizhou, China.
Objective:
To investigate the associations between long-term exposure to ambient air pollutants and incident cardiovascular disease (CVD) in a high-exposure setting and to evaluate whether multimorbidity affects this relationship in middle-aged and older Chinese individuals.
Methods:
Data from 7,692 adults in the China Health and Retirement Longitudinal Study (CHARLS), with up to 8 years of follow-up, were used. Long-term exposure to particulate matter ≤1 μm (PM1), ≤2.5 μm (PM2.5), ≤10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) was analyzed using high-resolution satellite-based estimates. Next, a least absolute shrinkage and selection operator regression multipollutant index was constructed. Hazard ratios for incident CVD were estimated using Cox proportional hazards models, and effect modification by multimorbidity was examined.
Results:
During follow-up, a total of 1,759 participants developed CVD. Compared with those in the lowest quartile, participants in the highest quartile of PM1, PM2.5, PM10, and NO2 exposure had hazard ratios of 1.35 (95% CI: 1.18-1.54), 1.58 (95% CI: 1.38-1.81), 1.63 (95% CI: 1.42-1.87), and 1.25 (95% CI: 1.09-1.44), respectively. Combined multipollutant exposure had the strongest effect, with an HR of 2.05 (95% CI: 1.78-2.37). The corresponding HRs were 2.27 (95% CI: 1.89-2.72) among participants without multimorbidity and 3.02 (95% CI: 2.44-3.73) among those with multimorbidity (P for interaction = 0.029).
Conclusion:
Long-term exposure to ambient air pollutants is associated with a substantially increased risk of CVD, particularly among individuals with multimorbidity. These findings highlight the need for multipollutant control strategies and targeted prevention efforts among clinically vulnerable populations.
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