Long-Term Exposure to Ultrafine Particulate and Cardiovascular Diseases: A Large-Scale, Multicenter Study in China

Ultrafine particulate matter (UFP) has been identified as a significant environmental risk for public health, yet the cardiovascular effects of long-term UFP exposure have been insufficiently explored. This study based on data from 98,797 participants across five provinces/regions in southwest China and UFP data from a high-resolution atmospheric chemistry model examined the associations between long-term UFP exposure and the prevalence of cardiovascular diseases (CVDs) in China. The findings reveal elevated prevalence of total and specific CVDs associated with a 3-year average UFP exposure. Specifically, the odds ratio for total CVDs was 1.17 (95% CI: 1.09, 1.24) for each interquartile range increase (5667 particles/cm³) in the 3-year average of UFP exposure. Additionally, UFP exposure was associated with significant increases in the prevalence of stroke (33%), coronary heart disease (19%), and hypertension (11%). The exposure-response relationships indicate no threshold for the cardiovascular effects of UFP exposure with linear increases in risks even at lower exposure levels. Older populations, minority groups, and urban residents experience a higher prevalence of CVDs associated with long-term UFP exposure. This large-scale, multicenter study in China provides novel epidemiological evidence that long-term UFP exposures increase the prevalence of total and several specific CVDs. The findings address a critical gap in understanding the cardiovascular effects of UFPs in developing countries with high exposure levels.