JMIR Publications

ABSTRACT

Background:

Long-term follow-up studies investigating the relationship between ambient air pollution and cardiovascular and cerebrovascular diseases (CVD) in rural Chinese populations remain limited.

Objective:

Investigating the impact of prolonged exposure to PM2.5 on CVD in rural areas of China.

Methods:

Based on a multi-center population-based prospective study, the adult rural residents (≥15 years old) from three study sites (Xiangtan, Hunan Province; Longxi, Gansu Province; and Zhongmu, Henan Province) with different PM2.5 exposure levels were tracked for the incidence of CVD events between 2013 and 2023. The relationship was assessed by applying the Cox proportional hazards model and the trend test.

Results:

A total of 15,502 participants were included in the study. During the 10-year follow-up period, for every 1 μg/m³ increase in PM2.5, the risks of CVD, Ischemic Stroke (IS), Coronary heart disease (CHD), Acute Coronary Syndrome (ACS), and Intracerebral Hemorrhage (ICH) increased by 5% (HR = 1.05, 95% CI: 1.04-1.06), 7% (HR = 1.07, 95% CI: 1.06-1.08), 8% (HR = 1.08, 95% CI: 1.07-1.09), 9% (HR = 1.09, 95% CI: 1.06-1.11) and 10% (HR = 1.10, 95% CI: (1.07-1.14), respectively. Furthermore, the risk in the high-exposure group (Q4) was found to be significantly higher than that in the low-exposure group (Q1) (P for trend <.001). The subgroup analysis indicated that the risk of CVD was higher among the elderly compared to individuals under 60 years of age, and the interaction effect was statistically significant (interaction P-value = .03).

Conclusions:

Our results indicate that long-term exposure to PM2.5 significantly increases the risk of CVD in rural areas of China. Moreover, there are regional differences and dose-response trends in the intensity of this correlation. Clinical Trial: Not available