Zhang Zhihang, An Ran, Guo Haoyan, Yang Xuanru
Department of Gynecology, Beijing Hepingli Hospital, Beijing, China.
Chinese Center for Disease Control and Prevention, Beijing, China.
Front Public Health. 2025 Jan 8;12:1487034. doi: 10.3389/fpubh.2024.1487034. eCollection 2024.
Evidence from extensive cohort studies about the individual and combined associations of air pollution and air temperature with cardiovascular disease (CVD) morbidity is limited. This study aimed to examine the long-term effects of PM exposure and air temperature on CVD based on a cohort study of middle-aged and older populations in China.
A total of 9,316 non-CVD adults (≥40 years old) who joined the China Health and Retirement Longitudinal Study between 2011 and 2018 were included in our analysis. The two-year average PM concentration and air temperature of the city where participants lived were calculated. The Cox proportional hazards model was conducted to analyze the associations of PM exposure and air temperature with CVD morbidity.
In the multivariable-adjusted model, each 10 μg/m rise in 2-y PM concentration was associated with an increased risk of developing CVD (hazard ratio [HR]: 1.30; 95% confidence interval [CI]: 1.27-1.32). Compared with individuals in the bearable temperature group, those with low temperatures had a higher risk of CVD (HR: 1.77; 95% CI: 1.53-2.04). Stratified analyses found that cardiovascular metabolic risk factors could not change these associations. Compared with individuals in the low-level PM exposure and bearable temperature group, those in the high-level PM exposure and low-temperature group had a 7.08 times higher risk of CVD (95% CI: 5.55-9.03).
Long-term PM exposure and low air temperature are associated with a higher risk of CVD. Consequently, efforts to reduce air pollution and enhance protection against cold temperatures are vital for mitigating CVD risk.
关于空气污染和气温与心血管疾病（CVD）发病率的个体及联合关联的广泛队列研究证据有限。本研究旨在基于一项针对中国中老年人群的队列研究，探讨颗粒物（PM）暴露和气温对心血管疾病的长期影响。
我们的分析纳入了2011年至2018年间参加中国健康与养老追踪调查的9316名无心血管疾病的成年人（≥40岁）。计算了参与者所在城市的两年平均PM浓度和气温。采用Cox比例风险模型分析PM暴露和气温与心血管疾病发病率的关联。
在多变量调整模型中，两年平均PM浓度每升高10μg/m，患心血管疾病的风险增加（风险比[HR]：1.30；95%置信区间[CI]：1.27 - 1.32）。与处于可耐受温度组的个体相比，低温组个体患心血管疾病的风险更高（HR：1.77；95% CI：1.53 - 2.04）。分层分析发现，心血管代谢危险因素并不能改变这些关联。与低水平PM暴露和可耐受温度组的个体相比，高水平PM暴露和低温组的个体患心血管疾病的风险高7.08倍（95% CI：5.55 - 9.03）。
长期PM暴露和低气温与心血管疾病风险较高相关。因此，努力减少空气污染和加强防寒对于降低心血管疾病风险至关重要。
