Abstract 4363728: Air pollutants, road traffic noise, and risk of valvular heart disease: a UK Biobank-based prospective study

Introduction: Air and noise pollution are recognized public health concerns. However, their long-term impact on valvular heart disease (VHD) remains unclear. Methods: This study analyzed 453,413 participants from the UK Biobank. Air pollution was quantified using the air pollution score based on PM 2.5 , PM 2.5-10 , PM 10 , NO x , and NO 2 levels. Road traffic noise (L den and L night ) exposure was estimated based on baseline residential addresses. Participants were categorized into quintiles (Q1-Q5) of exposure. VHD diagnoses were identified from hospitalization and cause-of-death records. Multivariable Cox proportional hazard models were used to assess the association between pollution exposures and VHD risk, presented as hazard ratios (HR) with 95% confidence intervals (CI). Results: During a median follow-up of 13.9 years, 18,806 cases of VHD were recorded. Participants exposed to the highest levels of pollution exposures had a significantly increased risk of developing VHD compared to those in the lowest exposure group (Q5 vs. Q1: air pollution score [HR 1.73, 95% CI 1.61-1.87], PM 2.5 [HR 1.69, 95% CI 1.57-1.82], PM 2.5-10 [HR 1.43, 95% CI 1.34-1.53], PM 10 [HR 1.29, 95% CI 1.22-1.36], NO 2 [HR 1.59, 95% CI 1.47-1.71], NO X [HR 1.64, 95% CI 1.53-1.77], L den [HR 1.66, 95% CI 1.56-1.77], and L night [HR 1.67, 95% CI 1.57-1.78]). These associations persisted significantly regardless of the genetic risk to VHD and extended across all VHD subtypes, including non-rheumatic, rheumatic, aortic, mitral, tricuspid, and pulmonary valve diseases. Conclusion: This study demonstrates a significantly positive association between long-term exposure to air and noise pollution and increased VHD risk.