Long-term exposure to ambient air pollution and incident cardiovascular disease in adults with cardiovascular–kidney–metabolic stages 0–3: a nationwide prospective cohort study in China

Dec 15, 2025Scientific reports

Long-term air pollution exposure and new heart and blood vessel disease in adults with early to moderate heart, kidney, or metabolism problems in China

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Abstract

During a median follow-up of 6.9 years, 896 participants developed cardiovascular disease (CVD).

  • Each 10 µg/m³ increase in baseline (PM) or nitrogen monoxide (NO) is associated with a 20% higher risk of CVD.
  • Time-varying models confirm that long-term exposure to ozone is also linked to increased CVD risk.
  • Non-linear exposure-response relationships suggest specific thresholds for PM and NO at 39.64 µg/m³ and 39.86 µg/m³, respectively.
  • Multipollutant models indicate a positive mixture effect on CVD risk, primarily driven by PM.
  • Stronger associations with CVD risk are observed in participants from eastern China.

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Key numbers

1.20
Increase in CVD Risk per 10 µg/m³
for baseline exposure
1.20
Increase in CVD Risk per 10 µg/m³ NO
for baseline NO exposure
896 of 6321
CVD Incidence in Study Population
Total incident CVD cases among participants

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