Associations between main ambient air pollutants and ischaemic heart disease risk in the UK biobank: A prospective cohort study

Feb 27, 2025Public health

Links between common air pollutants and risk of heart disease in the UK population

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Abstract

In a median follow-up of 12.5 years, 23,721 out of 398,547 participants were diagnosed with ischaemic heart disease (IHD).

For every 1-μg/m³ increase in particulate matter (PM) and nitrogen oxides (NO), the risk of IHD increased by 2.6% and 0.2%, respectively.
Increasing quartiles of PM levels were associated with hazard ratios for IHD of 1.035, 1.043, and 1.063 compared to the lowest quartile.
Long-term exposure to multiple air pollutants was significantly associated with an elevated risk of IHD, with a hazard ratio of 1.029.
The exposure-response relationship for IHD risk and air pollutants was linear.

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OBJECTIVES: Air pollutants have been associated with multiple cardiovascular diseases, but evidence on the long-term and combined effects of air pollutants on the incidence of ischaemic heart disease (IHD) remains limited.

STUDY DESIGN: Prospective cohort study.

METHODS: A total of 398,547 participants from the UK Biobank were included in this prospective cohort study. Concentrations of air pollutants were calculated using the Land Use Regression (LUR) model, including particulate matter (PM) [PM, PM, PM] and nitrogen oxides (NOand NO). Cox proportional hazards models and restricted cubic spline models were utilised to detect associations between air pollutants and IHD incidence. A novel air pollution score was proposed to indicate the synergistic effect of five air pollutants by combining variance contribution and eigenvalue of each pollutant in principal components analysis (PCA). 2.5 10-2.5 10x2

RESULTS: In a median follow-up of 12.5 years, 23,721 of 398,547 participants were diagnosed with IHD. For every 1-μg/mincrease, the risk of IHD was 1.026 (95 % confidence interval [CI]: 1.012-1.040) and 1.002 (95 % CI: 1.001-1.003) for PMand NO, respectively. This study found that for every increase in quartile of PMlevel, the hazard ratios (HRs) for IHD were 1.035 (95 % CI: 0.998-1.073), 1.043 (95 % CI: 1.005-1.082) and 1. 063 (95 % CI: 1.022-1.106) compared with the lowest quartile. Long-term estimated exposure to multiple air pollutants showed a significant association with elevated risk of IHD (HRs = 1.029, 95 % CI: 1.007-1.051) and the exposure-response curve was linear. 3 2.5x2.5

CONCLUSIONS: Among UK adults, long-term and synchronous exposure to multiple air contaminants was associated with an increased risk of IHD.

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Associations between main ambient air pollutants and ischaemic heart disease risk in the UK biobank: A prospective cohort study

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