Joint exposure to various ambient air pollutants and incident heart failure: a prospective analysis in UK Biobank
- 21 April 2021
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 42 (16), 1582-1591
- https://doi.org/10.1093/eurheartj/ehaa1031
Abstract
Little is known about the relation between the long-term joint exposure to various ambient air pollutants and the incidence of heart failure (HF). We aimed to assess the joint association of various air pollutants with HF risk and examine the modification effect of the genetic susceptibility. This study included 432 530 participants free of HF, atrial fibrillation, or coronary heart disease in the UK Biobank study. All participants were enrolled from 2006 to 2010 and followed up to 2018. The information on particulate matter (PM) with diameters ≤2.5 µm (PM2.5), ≤10 µm (PM10), and between 2.5 and 10 µm (PM2.5–10) as well as nitrogen oxides (NO2 and NOx) was collected. We newly proposed an air pollution score to assess the joint exposure to the five air pollutants through summing each pollutant concentration weighted by the regression coefficients with HF from single-pollutant models. We also calculated the weighted genetic risk score of HF. During a median of 10.1 years (4 346 642 person-years) of follow-up, we documented 4201 incident HF. The hazard ratios (HRs) [95% confidence interval (CI)] of HF for a 10 µg/m3 increase in PM2.5, PM10, PM2.5–10, NO2, and NOx were 1.85 (1.34–2.55), 1.61 (1.30–2.00), 1.13 (0.80–1.59), 1.10 (1.04–1.15), and 1.04 (1.02–1.06), respectively. We found that the air pollution score was associated with an increased risk of incident HF in a dose–response fashion. The HRs (95% CI) of HF were 1.16 (1.05–1.28), 1.19 (1.08–1.32), 1.21 (1.09–1.35), and 1.31 (1.17–1.48) in higher quintile groups compared with the lowest quintile of the air pollution score (P trend 2.5, PM10, PM2.5–10, NO2, and NOx is associated with an elevated risk of incident HF in an additive manner. Our findings highlight the importance to comprehensively assess various air pollutants in relation to the HF risk.Keywords
Funding Information
- National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383, DK078616)
- Fogarty International Center (TW010790)
- American Heart Association Scientist Development Award (0730094N)
- National Institute of General Medical Sciences (P20GM109036)
- China Scholarship Council
- United States of America (201906010346)
This publication has 53 references indexed in Scilit:
- Global association of air pollution and heart failure: a systematic review and meta-analysisThe Lancet, 2013
- Practical Advancement of Multipollutant Scientific and Risk Assessment Approaches for Ambient Air PollutionEnvironmental Health Perspectives, 2012
- Cardiovascular Remodeling in Response to Long-Term Exposure to Fine Particulate Matter Air PollutionCirculation: Heart Failure, 2012
- Using cross-validation to evaluate predictive accuracy of survival risk classifiers based on high-dimensional dataBriefings in Bioinformatics, 2011
- Heart Disease and Stroke Statistics—2011 UpdateCirculation, 2011
- A multilocus genetic risk score for coronary heart disease: case-control and prospective cohort analysesThe Lancet, 2010
- Protecting Human Health From Air PollutionEpidemiology, 2010
- Is There Evidence for Synergy Among Air Pollutants in Causing Health Effects?Environmental Health Perspectives, 2009
- PM(10) exposure, gaseous pollutants, and daily mortality in Inchon, South Korea.Environmental Health Perspectives, 1999
- Daily time series for cardiovascular hospital admissions and previous day's air pollution in London, UK.Occupational and Environmental Medicine, 1997