Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
BACKGROUND: Most studies of long-term exposure to outdoor fine particulate matter (PM2·5) and cardiovascular disease are from high-income countries with relatively low PM2·5 concentrations. It is unclear whether risks are similar in low-income and middle-income countries (LMICs) and how outdoor PM2·...
id |
ftaurorahc:oai:institutionalrepository.aah.org:pop-1026 |
---|---|
record_format |
openpolar |
institution |
Open Polar |
collection |
Aurora Health Care Digital Repository |
op_collection_id |
ftaurorahc |
language |
unknown |
topic |
Cardiology Advocate Aurora Research Institute |
spellingShingle |
Cardiology Advocate Aurora Research Institute Hystad, Perry Larkin, Andrew Rangarajan, Sumathy AlHabib, Khalid F Avezum, Álvaro Calik, Kevser Burcu Tumerdem Chifamba, Jephat Dans, Antonio Diaz, Rafael du Plessis, Johan L Gupta, Rajeev Iqbal, Romaina Khatib, Rasha Kelishadi, Roya Lanas, Fernando Liu, Zhiguang Lopez-Jaramillo, Patricio Nair, Sanjeev Poirier, Paul Rahman, Omar Rosengren, Annika Swidan, Hany Tse, Lap Ah Wei, Li Wielgosz, Andreas Yeates, Karen Yusoff, Khalid Zatoński, Tomasz Burnett, Rick Yusuf, Salim Brauer, Michael Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
topic_facet |
Cardiology Advocate Aurora Research Institute |
description |
BACKGROUND: Most studies of long-term exposure to outdoor fine particulate matter (PM2·5) and cardiovascular disease are from high-income countries with relatively low PM2·5 concentrations. It is unclear whether risks are similar in low-income and middle-income countries (LMICs) and how outdoor PM2·5 contributes to the global burden of cardiovascular disease. In our analysis of the Prospective Urban and Rural Epidemiology (PURE) study, we aimed to investigate the association between long-term exposure to PM2·5 concentrations and cardiovascular disease in a large cohort of adults from 21 high-income, middle-income, and low-income countries. METHODS: In this multinational, prospective cohort study, we studied 157 436 adults aged 35-70 years who were enrolled in the PURE study in countries with ambient PM2·5 estimates, for whom follow-up data were available. Cox proportional hazard frailty models were used to estimate the associations between long-term mean community outdoor PM2·5 concentrations and cardiovascular disease events (fatal and non-fatal), cardiovascular disease mortality, and other non-accidental mortality. FINDINGS: Between Jan 1, 2003, and July 14, 2018, 157 436 adults from 747 communities in 21 high-income, middle-income, and low-income countries were enrolled and followed up, of whom 140 020 participants resided in LMICs. During a median follow-up period of 9·3 years (IQR 7·8-10·8; corresponding to 1·4 million person-years), we documented 9996 non-accidental deaths, of which 3219 were attributed to cardiovascular disease. 9152 (5·8%) of 157 436 participants had cardiovascular disease events (fatal and non-fatal incident cardiovascular disease), including 4083 myocardial infarctions and 4139 strokes. Mean 3-year PM2·5 at cohort baseline was 47·5 μg/m3 (range 6-140). In models adjusted for individual, household, and geographical factors, a 10 μg/m3 increase in PM2·5 was associated with increased risk for cardiovascular disease events (hazard ratio 1·05 [95% CI 1·03-1·07]), myocardial infarction (1·03 ... |
format |
Text |
author |
Hystad, Perry Larkin, Andrew Rangarajan, Sumathy AlHabib, Khalid F Avezum, Álvaro Calik, Kevser Burcu Tumerdem Chifamba, Jephat Dans, Antonio Diaz, Rafael du Plessis, Johan L Gupta, Rajeev Iqbal, Romaina Khatib, Rasha Kelishadi, Roya Lanas, Fernando Liu, Zhiguang Lopez-Jaramillo, Patricio Nair, Sanjeev Poirier, Paul Rahman, Omar Rosengren, Annika Swidan, Hany Tse, Lap Ah Wei, Li Wielgosz, Andreas Yeates, Karen Yusoff, Khalid Zatoński, Tomasz Burnett, Rick Yusuf, Salim Brauer, Michael |
author_facet |
Hystad, Perry Larkin, Andrew Rangarajan, Sumathy AlHabib, Khalid F Avezum, Álvaro Calik, Kevser Burcu Tumerdem Chifamba, Jephat Dans, Antonio Diaz, Rafael du Plessis, Johan L Gupta, Rajeev Iqbal, Romaina Khatib, Rasha Kelishadi, Roya Lanas, Fernando Liu, Zhiguang Lopez-Jaramillo, Patricio Nair, Sanjeev Poirier, Paul Rahman, Omar Rosengren, Annika Swidan, Hany Tse, Lap Ah Wei, Li Wielgosz, Andreas Yeates, Karen Yusoff, Khalid Zatoński, Tomasz Burnett, Rick Yusuf, Salim Brauer, Michael |
author_sort |
Hystad, Perry |
title |
Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
title_short |
Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
title_full |
Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
title_fullStr |
Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
title_full_unstemmed |
Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study |
title_sort |
associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (pure): a prospective cohort study |
publisher |
Advocate Aurora Health Institutional Repository |
publishDate |
2020 |
url |
https://institutionalrepository.aah.org/pop/27 https://doi.org/10.1016/S2542-5196(20)30103-0 https://aurorahealthcare.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWckFClKcIhSpcqlYi2_ixeaAKqa26gBASKhRxs7xx3K5ok9XuRlw58jv5Jcw4zraOeB_3y9iONzP258fMEMLZMI56YwJoSaIxkrdQOTMsybQwJtbAbUXCmcEP_-lNdvAyOf6Y7w_I7i8O9NG1F1Y0sHwCxdlm8Q7HNAURLNmvY1gZNMzk9fByjwXqT2wGxlWhSyeen9fkTU82ir83S11hof07lF6kUTs7jdf_uSO3yS1HRMP9VnPukEFZ3SXBW-DQ9dxutYdb4eH5FAit_XVvMNi7UPPPL658z8XeroXC9kltwrpZ6rqe-7gBIusjM6uvmDis90BNe2VnmIkZ2-rJVTos7E1ah7dwd63WF3ZnUD44rUI6Sh32_eu3FhU86Yt1_mq9zqJbTsioD2LsZ4dEXXmw6K7pZ07swm4K_YUgdvO8_vIbSSdoM37gpkcHb7f4u5PjIwftPO8qDUG7OgfbfjVnsBrzMRt_2EH3ycn46MPhq8hl0IgKlgsaqdgkBliaBh6nMddAqnmKB-NGcMYFU0orYPRFOQHxojRZgQHkSjBIzmGtG_MH5KZCT4tqaT0y9UMSjmKqMewhrNWFyE2mFKclLfJikpTcxCogw86C5KyNmCJXVwlR5yXqvGSxtDov44AcoJ2thDHguQXAWqQbP2VOMRYdy_JJRoXK0gxnx1QXCTUFtK4DknVWKh13bDkhVDX9U_tPO6uWMLbigZmqyrpZSGS3OAFSEZDUM3fvZf0n1fTMRmlPxSgVIg3IVjsweEVOm5kE6LSRi1LCf88pffT_PdggNxhuA9nNwcdkbTlvyidkXTVzZCyre6Sb5Fr8frxpx8gfO0m7PA |
genre |
Aurora Research Institute |
genre_facet |
Aurora Research Institute |
op_source |
Population Health and Public Health |
op_relation |
https://institutionalrepository.aah.org/pop/27 doi:10.1016/S2542-5196(20)30103-0 https://aurorahealthcare.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWckFClKcIhSpcqlYi2_ixeaAKqa26gBASKhRxs7xx3K5ok9XuRlw58jv5Jcw4zraOeB_3y9iONzP258fMEMLZMI56YwJoSaIxkrdQOTMsybQwJtbAbUXCmcEP_-lNdvAyOf6Y7w_I7i8O9NG1F1Y0sHwCxdlm8Q7HNAURLNmvY1gZNMzk9fByjwXqT2wGxlWhSyeen9fkTU82ir83S11hof07lF6kUTs7jdf_uSO3yS1HRMP9VnPukEFZ3SXBW-DQ9dxutYdb4eH5FAit_XVvMNi7UPPPL658z8XeroXC9kltwrpZ6rqe-7gBIusjM6uvmDis90BNe2VnmIkZ2-rJVTos7E1ah7dwd63WF3ZnUD44rUI6Sh32_eu3FhU86Yt1_mq9zqJbTsioD2LsZ4dEXXmw6K7pZ07swm4K_YUgdvO8_vIbSSdoM37gpkcHb7f4u5PjIwftPO8qDUG7OgfbfjVnsBrzMRt_2EH3ycn46MPhq8hl0IgKlgsaqdgkBliaBh6nMddAqnmKB-NGcMYFU0orYPRFOQHxojRZgQHkSjBIzmGtG_MH5KZCT4tqaT0y9UMSjmKqMewhrNWFyE2mFKclLfJikpTcxCogw86C5KyNmCJXVwlR5yXqvGSxtDov44AcoJ2thDHguQXAWqQbP2VOMRYdy_JJRoXK0gxnx1QXCTUFtK4DknVWKh13bDkhVDX9U_tPO6uWMLbigZmqyrpZSGS3OAFSEZDUM3fvZf0n1fTMRmlPxSgVIg3IVjsweEVOm5kE6LSRi1LCf88pffT_PdggNxhuA9nNwcdkbTlvyidkXTVzZCyre6Sb5Fr8frxpx8gfO0m7PA |
op_doi |
https://doi.org/10.1016/S2542-5196(20)30103-0 |
container_title |
The Lancet Planetary Health |
container_volume |
4 |
container_issue |
6 |
container_start_page |
e235 |
op_container_end_page |
e245 |
_version_ |
1772180756655767552 |
spelling |
ftaurorahc:oai:institutionalrepository.aah.org:pop-1026 2023-07-23T04:18:26+02:00 Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study Hystad, Perry Larkin, Andrew Rangarajan, Sumathy AlHabib, Khalid F Avezum, Álvaro Calik, Kevser Burcu Tumerdem Chifamba, Jephat Dans, Antonio Diaz, Rafael du Plessis, Johan L Gupta, Rajeev Iqbal, Romaina Khatib, Rasha Kelishadi, Roya Lanas, Fernando Liu, Zhiguang Lopez-Jaramillo, Patricio Nair, Sanjeev Poirier, Paul Rahman, Omar Rosengren, Annika Swidan, Hany Tse, Lap Ah Wei, Li Wielgosz, Andreas Yeates, Karen Yusoff, Khalid Zatoński, Tomasz Burnett, Rick Yusuf, Salim Brauer, Michael 2020-06-01T07:00:00Z https://institutionalrepository.aah.org/pop/27 https://doi.org/10.1016/S2542-5196(20)30103-0 https://aurorahealthcare.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWckFClKcIhSpcqlYi2_ixeaAKqa26gBASKhRxs7xx3K5ok9XuRlw58jv5Jcw4zraOeB_3y9iONzP258fMEMLZMI56YwJoSaIxkrdQOTMsybQwJtbAbUXCmcEP_-lNdvAyOf6Y7w_I7i8O9NG1F1Y0sHwCxdlm8Q7HNAURLNmvY1gZNMzk9fByjwXqT2wGxlWhSyeen9fkTU82ir83S11hof07lF6kUTs7jdf_uSO3yS1HRMP9VnPukEFZ3SXBW-DQ9dxutYdb4eH5FAit_XVvMNi7UPPPL658z8XeroXC9kltwrpZ6rqe-7gBIusjM6uvmDis90BNe2VnmIkZ2-rJVTos7E1ah7dwd63WF3ZnUD44rUI6Sh32_eu3FhU86Yt1_mq9zqJbTsioD2LsZ4dEXXmw6K7pZ07swm4K_YUgdvO8_vIbSSdoM37gpkcHb7f4u5PjIwftPO8qDUG7OgfbfjVnsBrzMRt_2EH3ycn46MPhq8hl0IgKlgsaqdgkBliaBh6nMddAqnmKB-NGcMYFU0orYPRFOQHxojRZgQHkSjBIzmGtG_MH5KZCT4tqaT0y9UMSjmKqMewhrNWFyE2mFKclLfJikpTcxCogw86C5KyNmCJXVwlR5yXqvGSxtDov44AcoJ2thDHguQXAWqQbP2VOMRYdy_JJRoXK0gxnx1QXCTUFtK4DknVWKh13bDkhVDX9U_tPO6uWMLbigZmqyrpZSGS3OAFSEZDUM3fvZf0n1fTMRmlPxSgVIg3IVjsweEVOm5kE6LSRi1LCf88pffT_PdggNxhuA9nNwcdkbTlvyidkXTVzZCyre6Sb5Fr8frxpx8gfO0m7PA unknown Advocate Aurora Health Institutional Repository https://institutionalrepository.aah.org/pop/27 doi:10.1016/S2542-5196(20)30103-0 https://aurorahealthcare.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWckFClKcIhSpcqlYi2_ixeaAKqa26gBASKhRxs7xx3K5ok9XuRlw58jv5Jcw4zraOeB_3y9iONzP258fMEMLZMI56YwJoSaIxkrdQOTMsybQwJtbAbUXCmcEP_-lNdvAyOf6Y7w_I7i8O9NG1F1Y0sHwCxdlm8Q7HNAURLNmvY1gZNMzk9fByjwXqT2wGxlWhSyeen9fkTU82ir83S11hof07lF6kUTs7jdf_uSO3yS1HRMP9VnPukEFZ3SXBW-DQ9dxutYdb4eH5FAit_XVvMNi7UPPPL658z8XeroXC9kltwrpZ6rqe-7gBIusjM6uvmDis90BNe2VnmIkZ2-rJVTos7E1ah7dwd63WF3ZnUD44rUI6Sh32_eu3FhU86Yt1_mq9zqJbTsioD2LsZ4dEXXmw6K7pZ07swm4K_YUgdvO8_vIbSSdoM37gpkcHb7f4u5PjIwftPO8qDUG7OgfbfjVnsBrzMRt_2EH3ycn46MPhq8hl0IgKlgsaqdgkBliaBh6nMddAqnmKB-NGcMYFU0orYPRFOQHxojRZgQHkSjBIzmGtG_MH5KZCT4tqaT0y9UMSjmKqMewhrNWFyE2mFKclLfJikpTcxCogw86C5KyNmCJXVwlR5yXqvGSxtDov44AcoJ2thDHguQXAWqQbP2VOMRYdy_JJRoXK0gxnx1QXCTUFtK4DknVWKh13bDkhVDX9U_tPO6uWMLbigZmqyrpZSGS3OAFSEZDUM3fvZf0n1fTMRmlPxSgVIg3IVjsweEVOm5kE6LSRi1LCf88pffT_PdggNxhuA9nNwcdkbTlvyidkXTVzZCyre6Sb5Fr8frxpx8gfO0m7PA Population Health and Public Health Cardiology Advocate Aurora Research Institute text 2020 ftaurorahc https://doi.org/10.1016/S2542-5196(20)30103-0 2023-07-05T20:24:44Z BACKGROUND: Most studies of long-term exposure to outdoor fine particulate matter (PM2·5) and cardiovascular disease are from high-income countries with relatively low PM2·5 concentrations. It is unclear whether risks are similar in low-income and middle-income countries (LMICs) and how outdoor PM2·5 contributes to the global burden of cardiovascular disease. In our analysis of the Prospective Urban and Rural Epidemiology (PURE) study, we aimed to investigate the association between long-term exposure to PM2·5 concentrations and cardiovascular disease in a large cohort of adults from 21 high-income, middle-income, and low-income countries. METHODS: In this multinational, prospective cohort study, we studied 157 436 adults aged 35-70 years who were enrolled in the PURE study in countries with ambient PM2·5 estimates, for whom follow-up data were available. Cox proportional hazard frailty models were used to estimate the associations between long-term mean community outdoor PM2·5 concentrations and cardiovascular disease events (fatal and non-fatal), cardiovascular disease mortality, and other non-accidental mortality. FINDINGS: Between Jan 1, 2003, and July 14, 2018, 157 436 adults from 747 communities in 21 high-income, middle-income, and low-income countries were enrolled and followed up, of whom 140 020 participants resided in LMICs. During a median follow-up period of 9·3 years (IQR 7·8-10·8; corresponding to 1·4 million person-years), we documented 9996 non-accidental deaths, of which 3219 were attributed to cardiovascular disease. 9152 (5·8%) of 157 436 participants had cardiovascular disease events (fatal and non-fatal incident cardiovascular disease), including 4083 myocardial infarctions and 4139 strokes. Mean 3-year PM2·5 at cohort baseline was 47·5 μg/m3 (range 6-140). In models adjusted for individual, household, and geographical factors, a 10 μg/m3 increase in PM2·5 was associated with increased risk for cardiovascular disease events (hazard ratio 1·05 [95% CI 1·03-1·07]), myocardial infarction (1·03 ... Text Aurora Research Institute Aurora Health Care Digital Repository The Lancet Planetary Health 4 6 e235 e245 |