The Association Of Pm10, Pm2.5-10, And Pm2.5 With Risk Of Incident Coronary Heart Disease And Stroke In A Nationwide Cohort Of Men

Abstract

Introduction: Chronic exposures to particulate matter (PM) have been associated with cardiovascular morbidity and mortality. We examined the impact of long-term exposures to PM on the risk of incident overall, nonfatal, and fatal coronary heart disease (CHD) and overall, ischemic, hemorrhagic, nonfatal, and fatal stroke among members of the US-wide Health Professionals Follow-Up Study (HPFS) prospective cohort. Methods: HPFS members were followed biennially between 1986-2006 to obtain information on incident disease and to update information on a number of cardiovascular disease risk factors. Time-varying PM10, PM2.5-10, and PM2.5 for the previous 12 months were calculated from monthly predictions at the address level. Multivariate adjusted Cox proportional hazards models were used to estimate [HR (95%CI)] of the association between each fraction of PM and each outcome among 43,371 CVD-free members of the HPFS, adjusting for CVD risk factors and other potential confounders. . Results: The mean (SD) levels of 12-month average PM10, PM2.5-10, and PM2.5 were 20.7 (6.2), 8.4 (4.7) and 12.3 (3.4) µg/m3; 4,402 CHD and 1,195 stroke cases occurred. There was no evidence of an increased risk of overall or nonfatal CHD or of overall, nonfatal, or ischemic stroke with increasing PM exposures. We observed increases in risk with each 10 µg/m3 increase in PM10 andPM2.5-10, for fatal CHD [1.10 (1.01-1.19) and 1.15 (1.03-1.29)]. We observed suggestive evidence for PM2.5 exposure with fatal CHD [1.06 (0.93-1.21)], and for PM10, PM2.5-10, and PM2.5 with hemorrhagic stroke [(1.14 (0.88-1.50); 1.16 (0.79-1.69); and 1.18 (0.76-1.83)] and fatal stroke [(1.10 (0.90-1.35); 1.16 (0.88-1.54); and 1.05 (0.75-1.48)]. Discussion: In this cohort of US men, PM10 and PM2.5-10 were associated with statistically significant increases in fatal CHD and suggestive associations of all size fractions with fatal and hemorrhagic stroke. Other cardiovascular outcomes were not related to PM exposures.