Does Physical Activity Modify the Association between Air Pollution and Recurrence of Cardiovascular Disease?
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ABSTRACT:
SUBMITTER: Raza W
PROVIDER: S-EPMC7967368 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
Does Physical Activity Modify the Association between Air Pollution and Recurrence of Cardiovascular Disease?
Raza Wasif W Krachler Benno B Forsberg Bertil B Sommar Johan Nilsson JN
International journal of environmental research and public health 20210305 5
We aimed to assess a possible interaction effect between physical activity and particulate air pollution exposure on recurrence of ischemic heart disease (IHD) and stroke. We followed 2221 adult participants comprising first time IHD (1403) and stroke (818) cases from the Västerbotten Intervention Program between 1 January 1990 to 31 December 2013. During mean follow-up times of 5.5 years, 428 and 156 participants developed IHD and stroke recurrence, respectively. PM2.5 concentrations above the ...[more]
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Project description:BACKGROUND:Recent experimental evidence suggests that nutritional supplementation can blunt adverse cardiopulmonary effects induced by acute air pollution exposure. However, whether usual individual dietary patterns can modify the association between long-term air pollution exposure and health outcomes has not been previously investigated. We assessed, in a large cohort with detailed diet information at the individual level, whether a Mediterranean diet modifies the association between long-term exposure to ambient air pollution and cardiovascular disease mortality risk. METHODS:The National Institutes of Health-American Association for Retired Persons Diet and Health Study, a prospective cohort (N=548 845) across 6 states and 2 cities in the United States and with a follow-up period of 17 years (1995-2011), was linked to estimates of annual average exposures to fine particulate matter and nitrogen dioxide at the residential census-tract level. The alternative Mediterranean Diet Index, which uses a 9-point scale to assess conformity with a Mediterranean-style diet, was constructed for each participant from information in cohort baseline dietary questionnaires. We evaluated mortality risks for cardiovascular disease, ischemic heart disease, cerebrovascular disease, or cardiac arrest associated with long-term air pollution exposure. Effect modification of the associations between exposure and the mortality outcomes by alternative Mediterranean Diet Index was examined via interaction terms. RESULTS:For fine particulate matter, we observed elevated and significant associations with cardiovascular disease (hazard ratio [HR] per 10 μg/m3, 1.13; 95% CI, 1.08-1.18), ischemic heart disease (HR, 1.16; 95% CI, 1.10-1.23), and cerebrovascular disease (HR, 1.15; 95% CI, 1.03-1.28). For nitrogen dioxide, we found significant associations with cardiovascular disease (HR per 10 ppb, 1.06; 95% CI, 1.04-1.08) and ischemic heart disease (HR, 1.08; 95% CI, 1.05-1.11). Analyses indicated that Mediterranean diet modified these relationships, as those with a higher alternative Mediterranean Diet Index score had significantly lower rates of cardiovascular disease mortality associated with long-term air pollution exposure ( P-interaction<0.05). CONCLUSIONS:A Mediterranean diet reduced cardiovascular disease mortality risk related to long-term exposure to air pollutants in a large prospective US cohort. Increased consumption of foods rich in antioxidant compounds may aid in reducing the considerable disease burden associated with ambient air pollution.
| S-EPMC6453737 | biostudies-literature
Project description:Background Physical activity (PA), particularly outdoor PA, may have dual effects on cardiovascular disease (CVD) risk: health benefits of exercise and potential harmful effects attributable to increased exposure to air pollution. We examined the combined effects of PA and air pollution on CVD. Methods and Results Sampling from a nationwide cohort study of the Korean National Health Insurance Service, we examined 189 771 adults aged ≥40 years who underwent health examination between 2009 and 2010. PA was measured with a questionnaire on the weekly frequency and intensity. Ambient levels of particulate matter 10, 2.5 (PM10, PM2.5) were estimated by the residency of participants. We conducted Cox proportional hazard regression analysis to estimate the relationship between CVD risk and combined effects of PA and air pollution. Subjects with moderate to vigorous PA ≥5 times/week and high PM10 exposure had lower risk of CVD (adjusted hazard ratio [aHR], 0.73; 95% CI, 0.62-0.87), coronary heart disease (aHR, 0.76; 95% CI, 0.59-0.98), and stroke (aHR, 0.70; 95% CI, 0.56-0.88). The inverse association between PA and CVD risk was consistent when the analysis was performed for subjects with low/moderate PM10 exposure. When using PM2.5 data, the results were also consistent. Conclusions Moderate to vigorous PA appeared to reduce the risk of CVD within groups of both high and low PM10 or PM2.5 levels. Further studies are needed to validate whether the health benefits of PA outweigh the potential harmful effects resulting from increased exposure to air pollution during PA.
| S-EPMC7429004 | biostudies-literature
Project description:BackgroundLong-term fine particulate matter (PM2.5) exposure is linked with cardiovascular disease, and disadvantaged status may increase susceptibility to air pollution-related health effects. In addition, there are concerns that this association may be partially explained by confounding by socioeconomic status (SES).ObjectivesWe examined the roles that individual- and neighborhood-level SES (NSES) play in the association between PM2.5 exposure and cardiovascular disease.MethodsThe study population comprised 51,754 postmenopausal women from the Women's Health Initiative Observational Study. PM2.5 concentrations were predicted at participant residences using fine-scale regionalized universal kriging models. We assessed individual-level SES and NSES (Census-tract level) across several SES domains including education, occupation, and income/wealth, as well as through an NSES score, which captures several important dimensions of SES. Cox proportional-hazards regression adjusted for SES factors and other covariates to determine the risk of a first cardiovascular event.ResultsA 5 ?g/m3 higher exposure to PM2.5 was associated with a 13% increased risk of cardiovascular event [hazard ratio (HR) 1.13; 95% confidence interval (CI): 1.02, 1.26]. Adjustment for SES factors did not meaningfully affect the risk estimate. Higher risk estimates were observed among participants living in low-SES neighborhoods. The most and least disadvantaged quartiles of the NSES score had HRs of 1.39 (95% CI: 1.21, 1.61) and 0.90 (95% CI: 0.72, 1.07), respectively.ConclusionsWomen with lower NSES may be more susceptible to air pollution-related health effects. The association between air pollution and cardiovascular disease was not explained by confounding from individual-level SES or NSES. Citation: Chi GC, Hajat A, Bird CE, Cullen MR, Griffin BA, Miller KA, Shih RA, Stefanick ML, Vedal S, Whitsel EA, Kaufman JD. 2016. Individual and neighborhood socioeconomic status and the association between air pollution and cardiovascular disease. Environ Health Perspect 124:1840-1847;?http://dx.doi.org/10.1289/EHP199.
| S-EPMC5132637 | biostudies-literature
Project description:BackgroundSedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear.Methods and resultsWe analyzed data from 113 918 newly diagnosed patients with dyslipidemia (2009-2012) without prior CVD, sourced from the Korea National Health Insurance Service. Ambient particulate matter (PM) 2.5 and PM10 levels were collected from the National Ambient Air Monitoring System in South Korea. Changes in PA, measured in metabolic equivalents of task-min/wk before and after dyslipidemia diagnosis, were evaluated for associations with air pollution levels and CVD risk using Cox proportional hazards regression. Patients were followed from January 1, 2013, until CVD onset, death, or December 31, 2021. Among patients exposed to low to moderate PM2.5 levels (≤25 μg/m3), increasing PA from inactive to ≥1000 metabolic equivalents of tasks-min/wk was associated with a lower risk of CVD (adjusted hazard ratio, 0.82 [95% CI, 0.70-0.97]; P for trend=0.022). In high PM2.5 (>25 μg/m3) conditions, increasing PA from inactive and decreasing PA from ≥1000 metabolic equivalents of task-min/wk was associated with reduced (P for trend=0.010) and elevated (P for trend=0.028) CVD risks, respectively. For PM10, increased PA was linked to reduced CVD risk (P for trend=0.002) and decreased PA to elevated risk (P for trend=0.042) in low to moderate PM10 (≤50 μg/m3) conditions, though benefits diminished at high PM10 (>50 μg/m3) exposures.ConclusionsPromoting PA, while considering the high potential cardiovascular risk associated with air pollution, may be an effective intervention against CVD in patients with dyslipidemia.
| S-EPMC11681569 | biostudies-literature
Project description:Polymorphisms in genes involved in the oxidative stress response may partially explain the documented heterogeneous associations between traffic-related air pollution (TRAP) exposure and asthma and allergies in children. We investigated whether the GSTT1, GSTM1 and GSTP1 gene polymorphisms modified the associations between TRAP exposure during the first year of life and asthma, wheeze and hay fever in adolescence. We used a birth cohort of 620 high risk infants from the Melbourne Atopy Cohort Study. TRAP exposure during the first year of life was defined as the cumulative length of major roads within 150 m of each participant's residence during the first year of life. Wheeze, asthma and hay fever were measured at ages 12 (n = 370) and 18 (n = 434) years. The associations and interactions with glutathione S-transferases (GST s) were investigated using regression models. Overall, there was no relationship between TRAP exposure during the first year of life and current asthma, wheeze and hay fever at ages 12 or 18 years. However, in GSTT1 null carriers, every 100 m increase in cumulative lengths of major road exposure during the first year of life was associated with a 2.31-fold increased risk of wheeze and a 2.15-fold increased risk of asthma at 12 years. TRAP is associated with some respiratory outcomes in carriers of genetic polymorphisms in oxidative stress metabolism genes.
| S-EPMC4848941 | biostudies-literature
Project description:ImportanceEmerging yet contrasting evidence associates air pollution with incident dementia, and the potential role of cardiovascular disease (CVD) in this association is unclear.ObjectiveTo investigate the association between long-term exposure to air pollution and dementia and to assess the role of CVD in that association.Design, setting, and participantsData for this cohort study were extracted from the ongoing Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a longitudinal population-based study with baseline assessments from March 21, 2001, through August 30, 2004. Of the 5111 randomly selected residents in the Kungsholmen district of Stockholm 60 years or older and living at home or in institutions, 521 were not eligible (eg, due to death before the start of the study or no contact information). Among the remaining 4590 individuals, 3363 (73.3%) were assessed. For the current analysis, 2927 participants who did not have dementia at baseline were examined, with follow-up to 2013 (mean [SD] follow-up time, 6.01 [2.56] years). Follow-up was completed February 18, 2013, and data were analyzed from June 26, 2018, through June 20, 2019.ExposuresTwo major air pollutants (particulate matter ≤2.5 μm [PM2.5] and nitrogen oxide [NOx]) were assessed yearly from 1990, using dispersion models for outdoor levels at residential addresses.Main outcomes and measuresThe hazard of dementia was estimated using Cox proportional hazards regression models. The potential of CVD (ie, atrial fibrillation, ischemic heart disease, heart failure, and stroke) to modify and mediate the association between long-term exposure to air pollution and dementia was tested using stratified analyses and generalized structural equation modeling.ResultsAt baseline, the mean (SD) age of the 2927 participants was 74.1 (10.7) years, and 1845 (63.0%) were female. Three hundred sixty-four participants with incident dementia were identified. The hazard of dementia increased by as much as 50% per interquartile range difference in mean pollutant levels during the previous 5 years at the residential address (hazard ratio [HR] for difference of 0.88 μg/m3 PM2.5, 1.54 [95% CI, 1.33-1.78]; HR for difference of 8.35 μg/m3 NOx, 1.14 [95% CI, 1.01-1.29]). Heart failure (HR for PM2.5, 1.93 [95% CI, 1.54-2.43]; HR for NOx, 1.43 [95% CI, 1.17-1.75]) and ischemic heart disease (HR for PM2.5, 1.67 [95% CI, 1.32-2.12]; HR for NOx, 1.36 [95% CI, 1.07-1.71]) enhanced the dementia risk, whereas stroke appeared to be the most important intermediate condition, explaining 49.4% of air pollution-related dementia cases.Conclusions and relevanceThis study found that long-term exposure to air pollution was associated with a higher risk of dementia. Heart failure and ischemic heart disease appeared to enhance the association between air pollution and dementia, whereas stroke seemed to be an important intermediate condition between the association of air pollution exposure with dementia.
| S-EPMC7105952 | biostudies-literature
Project description:Extensive evidence has shown that air pollution increases the risk of cardiovascular disease (CVD) admissions. We aimed to explore the short-term effect of air pollution on CVD admissions in Lanzhou residents and their lag effects. Meteorological data, air pollution data, and a total of 309,561 daily hospitalizations for CVD among urban residents in Lanzhou were collected from 2013 to 2020. Distributed lag non-linear model was used to analyze the relationship between air pollutants and CVD admissions, stratified by gender, age, and season. PM2.5, NO2, and CO have the strongest harmful effects at lag03, while SO2 at lag3. The relative risks of CVD admissions were 1.0013(95% CI: 1.0003, 1.0023), 1.0032(95% CI: 1.0008, 1.0056), and 1.0040(95% CI: 1.0024, 1.0057) when PM2.5, SO2, and NO2 concentrations were increased by 10 μg/m³, respectively. Each 1 mg/m3 increase in CO concentration was associated with a relative risk of cardiovascular hospitalization of risk was 1.0909(95% CI: 1.0367, 1.1479). We observed a relative risk of 0.9981(95% CI: 0.9972, 0.9991) for each 10 μg/m³ increase in O3 for CVD admissions at lag06. We found a significant lag effects of air pollutants on CVD admissions. NO2 and CO pose a greater risk of hospitalization for women, while PM2.5 and SO2 have a greater impact on men. PM2.5, NO2, and CO have a greater impact on CVD admissions in individuals aged <65 years, whereas SO2 affects those aged ≥65 years. Our research indicates a possible short-term impact of air pollution on CVD. Local public health and environmental policies should take these preliminary findings into account.
| S-EPMC10762694 | biostudies-literature
Project description:Meniere's disease is thought to be a disorder of the inner ear function, affected by genetic and environmental factors. Several recent studies have shown that air pollution could affect middle and inner ear diseases. The purpose of this study was to investigate the relationship between the Meniere's disease occurrence and air pollution status in Korea. This study used a time-stratified case-crossover design. Hospital visit data by Meniere's disease were collected from the Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC) database. Daily air pollution data for sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and particulate matter (PM10: ≤ 10 μm in diameter, and PM2.5: ≤ 2.5 μm in diameter) were collected from the National Ambient air quality Monitoring Information System (NAMIS) database. We used two-stage analysis to assess the association between degree of air pollution and the occurrence of Meniere's disease. In the first stage, region-specific analysis was conducted to estimate the odds ratios (ORs) of Meniere's disease risk associated with each air pollutant exposure by using conditional logistic regression for matched case-control sets in 16 regions. In the second stage, region-specific ORs from the first stage were combined and the pooled effect estimates were derived through fixed and random effect meta-analysis. Subgroup analysis was conducted for age, sex, seasonality, and urbanization of residence. In total, 29,646 (32.1% males and 67.9% females) Meniere's disease cases were identified from Korea NHIS-NSC database between 2008 and 2015. Overall, SO2, NO2, CO, and PM10 showed significant correlation with Meniere's disease risk at immediate lags, and weaker correlation at delayed lags, whereas O3 showed slightly negative correlation at the immediate lag (lag0) and PM2.5 did not show strong correlation (SO2: 1.04 [95% confidence interval: 1.01, 1.06]; NO2: 1.08 [1.06, 1.11]; CO: 1.04 [1.02, 1.06]; O3: 0.96 [0.93, 0.99]: statistically significant ORs at lag0 are listed). These positive and negative associations between Meniere's disease and each air pollutant were generally stronger in the age of 40-64, female, summer (June-August) season, and urban subgroups. Our results showed that hospital visits for Meniere's disease were associated with the measured concentrations of ambient air pollutants SO2, NO2, CO, and PM10. Further studies are required to confirm these associations and find their mechanisms.
| S-EPMC8222348 | biostudies-literature
Project description:BackgroundAir pollution may exacerbate diabetes-related indicators; however, the longitudinal associations between air pollutant concentrations and glycemic markers remain unclear. In this prospective cohort study, we examined the longitudinal associations between air pollution and glycemic indicators among older individuals with normoglycemia at baseline and determined whether these associations differed according to changes in physical activity levels.MethodsOverall, 1,856 participants (mean age, 70.9 years) underwent baseline and 4-year follow-up surveys. We used linear mixed-effect models to examine the associations between previous 1-year exposures to air pollutants and glycemic indicators. We further investigated associations between previous 5-year exposures to air pollutants and glycemic indicators after the inverse probability of treatment weighting (IPTW). We explored effect modifications by the level of physical activity maintenance and changes in metabolic equivalent of task (METs) for physical activity.ResultsLevels of particulate matter with aerodynamic diameters ≤ 10 μm (PM10) and ≤ 2.5 μm, and nitrogen dioxide (NO2) were significantly associated with increased fasting blood glucose, Hemoglobin A1c, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) values. After IPTW, the associations remained significant for PM10 and NO2. The positive associations of NO2 with insulin and HOMA-IR remained significant in the maintained inactive group, but not in the maintained moderate-to-vigorous active group. The positive associations of PM10 or NO2 with insulin and HOMA-IR remained significant in the group with increased METs, but not in those with decreased METs. In the post-hoc analysis of non-linear relationships between an increase in METs and glycemic indicators, insulin and HOMA-IR remarkably increased in the higher PM10 and NO2 exposure group from the point of 12,000 and 13,500 METs-min/week increase, respectively.ConclusionsWe demonstrated longitudinal associations between air pollution exposures and increased insulin resistance in older individuals. Maintaining moderate-to-vigorous physical activity may mitigate the adverse effects of air pollution on insulin resistance. In older individuals dwelling in highly polluted areas, an increase of less than 12,000 METs-min/week may be beneficial for insulin resistance.
| S-EPMC11488365 | biostudies-literature
Project description:Objective: The purpose of this study was to investigate the sex correlations of particulate matters (PM2.5, PM10, PM2.5-10), NO2 and NOx with ASCVD risk in the UK Biobank population. Methods: Among 285,045 participants, pollutants were assessed and correlations between ASCVD risk were stratified by sex and estimated using multiple linear and logistic regressions adjusted for length of time at residence, education, income, physical activity, Townsend deprivation, alcohol, smocking pack years, BMI and rural/urban zone. Results: Males presented higher ASCVD risk than females (8.63% vs. 2.65%, p < 0.001). In males PM2.5, PM10, NO2, and NOx each were associated with an increased ASCVD risk >7.5% in the adjusted logistic models, with ORs [95% CI] for a 10 μg/m3 increase were 2.17 [1.87-2.52], 1.15 [1.06-1.24], 1.06 [1.04-1.08] and 1.05 [1.04-1.06], respectively. In females, the ORs for a 10 μg/m3 increase were 1.55 [1.19-2.05], 1.22 [1.06-1.42], 1.07 [1.03-1.10], and 1.04 [1.02-1.05], respectively. No association was observed in both sexes between ASCVD risk and PM2.5-10. Conclusion: Our findings may suggest the possible actions of air pollutants on ASCVD risk.
| S-EPMC10569126 | biostudies-literature