Evidence has shown that air pollution exposure and extreme temperature events (ETEs) were both associated with coronary heart disease (CHD) mortality, but their interaction was less appreciated. This study was to explore the individual and joint effects of air pollution and ETEs on CHD mortality. Numbers of Daily deaths from CHD were collected between 1st January 2013 and 31st December 2019. Daily mean levels of five air pollutants and daily mean temperature in Wuhan were also collected during the study period. We used generalized additive models with a quasi-Poisson distribution to fit the relationships between air pollution and CHD mortality. While distributed lag non-linear models were performed to explore the relationship between ETEs and CHD mortality. The interaction effect between air pollution and ETEs was considered by relative risk due to interaction (RERI), attributable proportion (AP) and Synergy index (S). In this study, a total of 51,247 CHD deaths were observed. We noticed that short-term exposure to PM10, NO2 and SO2 was positively associated with the elevated risk of CHD mortality. The relative risks (RR) for CHD mortality were 1.004 (1.001, 1.007), 1.011 (1.005, 1.016) and 1.015 (1.004, 1.026) with a 10 μg/m3 increment in PM10, NO2 and SO2, respectively. Besides, heatwave and cold spell events were both associated with a higher risk of CHD death [RR=1.202 (1.025, 1.410) for heatwave (HW09); RR=1.199 (1.078, 1.335) for cold spell (CS01)]. There were synergetic effects on CHD mortality between heatwave and PM10 with RERI=0.37 (0.22, 0.53). Short-term exposure to ambient PM10, NO2, SO2 and ETEs was associated with an elevated risk of death from CHD with a lag effect. There is a synergetic effect of heatwave and PM10 on CHD mortality. 

Associations between short-term exposure to air pollution, extreme temperature events and coronary heart disease mortality: A seven-year time-series study in Wuhan, China

Abstract Background Together with rapid urbanization, ambient nitrogen dioxide (NO 2 ) exposure has become a growing health threat. However, little is known about the urban–rural disparities in the health implications of short-term NO 2 exposure. This study aimed to compare the association between short-term NO 2 exposure and hospitalization for cardiovascular disease (CVD) among urban and rural residents in Shandong Province, China. Then, this study further explored the urban–rural disparities in the economic burden attributed to NO 2 and the explanation for the disparities. Methods Daily hospitalization data were obtained from an electronic medical records dataset covering a population of 5 million. In total, 303,217 hospital admissions for CVD were analyzed. A three-stage time-series analytic approach was used to estimate the county-level association and the attributed economic burden. Results For every 10-μg/m 3 increase in NO 2 concentrations, this study observed a significant percentage increase in hospital admissions on the day of exposure of 1.42% (95% CI 0.92 to 1.92%) for CVD. The effect size was slightly higher in urban areas, while the urban–rural difference was not significant. However, a more pronounced displacement phenomenon was found in rural areas, and the economic burden attributed to NO 2 was significantly higher in urban areas. At an annual average NO 2 concentration of 10 μg/m 3 , total hospital days and expenses in urban areas were reduced by 81,801 (44,831 to 118,191) days and 60,121 (33,002 to 86,729) thousand CNY, respectively, almost twice as much as in rural areas. Due to disadvantages in socioeconomic status and medical resources, despite similar air pollution levels in the urban and rural areas of our sample sites, the rural population tended to spend less on hospitalization services. Conclusions Short-term exposure to ambient NO 2 could lead to considerable health impacts in either urban or rural areas of Shandong Province, China. Moreover, urban–rural differences in socioeconomic status and medical resources contributed to the urban–rural disparities in the economic burden attributed to NO 2 exposure. The health implications of NO 2 exposure are a social problem in addition to an environmental problem. Thus, this study suggests a coordinated intervention system that targets environmental and social inequality factors simultaneously. 

Urban–rural disparities in the association of nitrogen dioxide exposure with cardiovascular disease risk in China: effect size and economic burden

Background: Traditionally, cardiovascular diseases have been associated with older age groups. However, recent observations indicate a shift, with a growing number of young individuals experiencing heart attacks. Objectives: This study sought to explore the various factors contributing to this alarming trend and to understand the underlying causes. Methods: A comprehensive review of available evidence was conducted to examine the factors contributing to the rise in heart attacks among the youth. The study delved into genetic predispositions, lifestyle choices, socioeconomic factors, and healthcare infrastructure. The research also considered the complex interplay of these factors and how they collectively influence heart health in younger populations. Results: The review revealed a concerning global trend of increasing heart attacks among younger individuals. Several factors were identified as contributors to this trend. Genetics played a role, but lifestyle choices, including sedentary habits, unhealthy diets, and tobacco use, were significant contributors. Socioeconomic factors and disparities in healthcare infrastructure further exacerbated the issue. The study also highlighted the importance of understanding the interplay between these factors, as they often compound the risks associated with each other. Conclusions: The rising incidence of heart attacks among the youth is a pressing global health concern. While genetics play a role, modifiable lifestyle factors are significant contributors. Addressing these factors, understanding their interplay, and implementing multifaceted approaches are crucial to tackling this issue effectively. The study underscores the need for comprehensive strategies, including public health campaigns, policy changes, and targeted interventions, to reverse this alarming trend. 

pdf/why-are-young-people-dying-of-heart-attacks-these-days-what-fgha3e701fa1.pdf

Why are young people dying of heart attacks these days: what is the evidence?

Ischemic stroke (IS), chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) account for a large burden of premature deaths. However, few studies have investigated the associations between fine particular matter (PM2.5) components and mortality of IS, COPD and DM. We aimed to examine these associations in Beijing, China. Data on daily mortality, air pollutants and meteorological factors from 2008 to 2011 in Beijing were collected. Daily concentrations of five PM2.5 components, namely, sulfate ion (SO42−), ammonium ion (NH4+), nitrate ion (NO3−), organic matter (OM) and black carbon (BC), were obtained from the Tracking Air Pollution (TAP) database in China. The association between PM2.5 components and daily deaths was explored using a quasi-Poisson regression with the distributed lag nonlinear model (DLNM). The average daily concentrations of SO42−, NH4+, NO3−, OM and BC were 11.24, 8.37, 12.00, 17.34 and 3.32 μg/m3, respectively. After adjusting for temperature, relative humidity, pressure, particulate matter less than 10 μm in aerodynamic diameter (PM10), nitrogen dioxide (NO2) and sulfur dioxide (SO2), an IQR increase in OM at lag day 2 and lag day 6 was associated with an increased DM mortality risk (RR 1.038; 95% CI: 1.005–1.071) and COPD mortality risk (RR 1.013; 95% CI: 1.001–1.026). An IQR increase in BC at lag day 0 and lag day 6 was associated with increased COPD mortality risk (RR 1.228; 95% CI: 1.017–1.48, RR 1.059; 95% CI: 1.001–1.121). Cumulative exposure to SO42− and NH4+ was associated with an increased mortality risk for IS, with the highest effect found for lag of 0–7 days (RR 1.085; 95% CI: 1.010–1.167, RR 1.083; 95% CI: 1.003–1.169). These effects varied by sex and age group. This study demonstrated associations of short-term exposure to PM2.5 components with increased risk of IS, COPD and DM mortality in the general population. Our study also highlighted susceptible subgroups.

Associations between PM2.5 Components and Mortality of Ischemic Stroke, Chronic Obstructive Pulmonary Disease and Diabetes in Beijing, China

This study investigates the relationship between extreme temperatures, air pollutants, and cardiovascular disease in Ondo State, Nigeria. Geographic Information System (GIS) satellite mapping techniques were utilized to analyze the spatial distribution of environmental parameters including methane, carbon monoxide, nitrogen dioxide, sulfur dioxide, and temperature across Ondo State. Data was obtained for the years 2020, 2021, and 2022 to allow for temporal analysis. The parameters exhibited some variations across different local government areas, indicating potential differences in exposure. 2020 data on cardiovascular disease and death cases revealed distinct spatial patterns, with northern regions showing higher disease burden compared to southern areas. The findings highlight the need for targeted public health interventions based on region-specific environmental and health profiles. Enhanced monitoring, continued research on emerging factors, and translation of evidence into policies and community initiatives is recommended to mitigate environmental risks and promote cardiovascular health across Ondo State. Overall, the study demonstrates the utility of GIS mapping for investigating complex connections between environmental factors and health outcomes to guide informed prevention strategies.

The Effect of Extreme Temperature and Air Pollutant on Cardiovascular Disease in Ondo-State Nigeria

Objective Emerging evidence has highlighted the possible links of environmental pollution with several cardiovascular diseases (CVDs). The current study aimed to explore the impact of short-term air pollution exposure on CHD hospitalization in Hefei. Methods Data about the daily number of CHD admissions (from 2014 to 2021) were retrieved from the First Affiliated Hospital of Anhui Medical University. Air pollutants and meteorological data were obtained from the China Environmental Monitoring Station and the China Meteorological Data Service Center, respectively. The correlation between air pollution and CHD hospitalization was assessed using distributed lag non-linear model (DLNM) and Poisson generalized linear regression. Results In the single-pollutant model, NO2, O3, and CO strongly correlated with CHD hospitalization rate. Specifically, exposure to NO2 (lag0, relative risk [RR]: 1.013, 95%CI: 1.002–1.024, per 10 μg/m3 increase) and CO (lag13, RR: 1.035, 95%CI: 1.001–1.071, per 1 μg/m3 increase) revealed a positive correlation with an increased rate of CHD hospitalization. Interestingly, O3 had a protective association with hospitalization of CHD (lag0, RR: 0.993, 95%CI: 0.988–0.999, per 10 μg/m3 increase). Similar results, to those of the single-pollutant model, were revealed following verification using two-pollutant models. Subgroup analyses indicated that young people, women, and people in hot seasons were more susceptible to NO2 exposure, while the elderly, women, and people in cold seasons were more susceptible to O3. Furthermore, the elderly were more susceptible to CO exposure. Conclusion Overall, exposure to NO2 and CO increases the rate of CHD hospitalization, but exposure to O3 shows a protective association with the rate of CHD hospitalization. Therefore, early preventive measures against air pollutants should be applied to protect vulnerable patients with CHD.

Association between air pollution exposure and coronary heart disease hospitalization in a humid sub-tropical region of China: A time-series study

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Association between air pollution exposure and coronary heart disease hospitalization in a humid sub-tropical region of China: A time-series study