Impact of Obesity and Ozone on the Association Between Particulate Air Pollution and Cardiovascular Disease and Stroke Mortality Among US Adults

Mohsen Mazidi, John R Speakman (Corresponding Author)

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Abstract

BACKGROUND: Cardiovascular diseases (CVDs) and stroke are the highest and third highest causes of death, respectively, in the whole United States. It is well established that both long- and short-term exposure to particulate air pollution (particulate matter with diameters <2.5 μm [PM2.5]) increases the risks of both CVD and stroke mortality.

METHODS AND RESULTS: We combined county-level data for CVD and stroke mortality, and prevalence of hypertension and obesity, with spatial patterns of PM2.5 and ozone in a cross-sectional ecological study. We found significant positive associations between both CVD (β=15.4, P<0.001) and stroke (β=2.7, P<0.001) mortality with PM2.5. Ozone had significant link with just CVD (β=1372.1, P<0.001). Once poverty, ethnicity, and education were taken into account, there were still significant positive associations between PM2.5 and both CVD (β=1.2, P<0.001) and stroke (β=1.1, P<0.001) mortality. Moreover, the association between CVD and ozone remained after adjustment for these factors (β=21.8, P<0.001). PM2.5 and ozone were independent risk factors. The impact of PM2.5 on CVD and stroke mortality was strongly dependent on the prevalence of obesity. Hypertension partially mediated the associations of PM2.5 and mortality from CVD and stroke.

CONCLUSIONS: There was a spatial association between PM2.5 exposure and the leading causes of death and disability in United States. The effect of PM2.5 was considerably greater in areas where obesity is more prevalent. Hypertension is a possible mediator of the association of PM2.5 and both CVD and stroke.

Original languageEnglish
Article numbere008006
JournalJournal of the American Heart Association
Volume7
Issue number11
Early online date30 May 2018
DOIs
Publication statusPublished - 2018

Fingerprint

Ozone
Air Pollution
Cardiovascular Diseases
Obesity
Myocardial Infarction
Mortality
Hypertension
Cause of Death
Stroke
Particulate Matter
Poverty
Cross-Sectional Studies
Education

Keywords

  • Journal Article
  • cardiovascular diseases
  • education
  • obesity
  • particulate matter
  • stroke
  • PM2.5

Cite this

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title = "Impact of Obesity and Ozone on the Association Between Particulate Air Pollution and Cardiovascular Disease and Stroke Mortality Among US Adults",
abstract = "BACKGROUND: Cardiovascular diseases (CVDs) and stroke are the highest and third highest causes of death, respectively, in the whole United States. It is well established that both long- and short-term exposure to particulate air pollution (particulate matter with diameters <2.5 μm [PM2.5]) increases the risks of both CVD and stroke mortality.METHODS AND RESULTS: We combined county-level data for CVD and stroke mortality, and prevalence of hypertension and obesity, with spatial patterns of PM2.5 and ozone in a cross-sectional ecological study. We found significant positive associations between both CVD (β=15.4, P<0.001) and stroke (β=2.7, P<0.001) mortality with PM2.5. Ozone had significant link with just CVD (β=1372.1, P<0.001). Once poverty, ethnicity, and education were taken into account, there were still significant positive associations between PM2.5 and both CVD (β=1.2, P<0.001) and stroke (β=1.1, P<0.001) mortality. Moreover, the association between CVD and ozone remained after adjustment for these factors (β=21.8, P<0.001). PM2.5 and ozone were independent risk factors. The impact of PM2.5 on CVD and stroke mortality was strongly dependent on the prevalence of obesity. Hypertension partially mediated the associations of PM2.5 and mortality from CVD and stroke.CONCLUSIONS: There was a spatial association between PM2.5 exposure and the leading causes of death and disability in United States. The effect of PM2.5 was considerably greater in areas where obesity is more prevalent. Hypertension is a possible mediator of the association of PM2.5 and both CVD and stroke.",
keywords = "Journal Article, cardiovascular diseases, education, obesity, particulate matter , stroke , PM2.5",
author = "Mohsen Mazidi and Speakman, {John R}",
note = "Funding 1000 Talents Professorship of the Chinese Government Royal Society Third World Academy of Sciences Presidential Studentship Chinese Academy of Sciences",
year = "2018",
doi = "10.1161/JAHA.117.008006",
language = "English",
volume = "7",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Impact of Obesity and Ozone on the Association Between Particulate Air Pollution and Cardiovascular Disease and Stroke Mortality Among US Adults

AU - Mazidi, Mohsen

AU - Speakman, John R

N1 - Funding 1000 Talents Professorship of the Chinese Government Royal Society Third World Academy of Sciences Presidential Studentship Chinese Academy of Sciences

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Cardiovascular diseases (CVDs) and stroke are the highest and third highest causes of death, respectively, in the whole United States. It is well established that both long- and short-term exposure to particulate air pollution (particulate matter with diameters <2.5 μm [PM2.5]) increases the risks of both CVD and stroke mortality.METHODS AND RESULTS: We combined county-level data for CVD and stroke mortality, and prevalence of hypertension and obesity, with spatial patterns of PM2.5 and ozone in a cross-sectional ecological study. We found significant positive associations between both CVD (β=15.4, P<0.001) and stroke (β=2.7, P<0.001) mortality with PM2.5. Ozone had significant link with just CVD (β=1372.1, P<0.001). Once poverty, ethnicity, and education were taken into account, there were still significant positive associations between PM2.5 and both CVD (β=1.2, P<0.001) and stroke (β=1.1, P<0.001) mortality. Moreover, the association between CVD and ozone remained after adjustment for these factors (β=21.8, P<0.001). PM2.5 and ozone were independent risk factors. The impact of PM2.5 on CVD and stroke mortality was strongly dependent on the prevalence of obesity. Hypertension partially mediated the associations of PM2.5 and mortality from CVD and stroke.CONCLUSIONS: There was a spatial association between PM2.5 exposure and the leading causes of death and disability in United States. The effect of PM2.5 was considerably greater in areas where obesity is more prevalent. Hypertension is a possible mediator of the association of PM2.5 and both CVD and stroke.

AB - BACKGROUND: Cardiovascular diseases (CVDs) and stroke are the highest and third highest causes of death, respectively, in the whole United States. It is well established that both long- and short-term exposure to particulate air pollution (particulate matter with diameters <2.5 μm [PM2.5]) increases the risks of both CVD and stroke mortality.METHODS AND RESULTS: We combined county-level data for CVD and stroke mortality, and prevalence of hypertension and obesity, with spatial patterns of PM2.5 and ozone in a cross-sectional ecological study. We found significant positive associations between both CVD (β=15.4, P<0.001) and stroke (β=2.7, P<0.001) mortality with PM2.5. Ozone had significant link with just CVD (β=1372.1, P<0.001). Once poverty, ethnicity, and education were taken into account, there were still significant positive associations between PM2.5 and both CVD (β=1.2, P<0.001) and stroke (β=1.1, P<0.001) mortality. Moreover, the association between CVD and ozone remained after adjustment for these factors (β=21.8, P<0.001). PM2.5 and ozone were independent risk factors. The impact of PM2.5 on CVD and stroke mortality was strongly dependent on the prevalence of obesity. Hypertension partially mediated the associations of PM2.5 and mortality from CVD and stroke.CONCLUSIONS: There was a spatial association between PM2.5 exposure and the leading causes of death and disability in United States. The effect of PM2.5 was considerably greater in areas where obesity is more prevalent. Hypertension is a possible mediator of the association of PM2.5 and both CVD and stroke.

KW - Journal Article

KW - cardiovascular diseases

KW - education

KW - obesity

KW - particulate matter

KW - stroke

KW - PM2.5

U2 - 10.1161/JAHA.117.008006

DO - 10.1161/JAHA.117.008006

M3 - Article

C2 - 29848499

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 11

M1 - e008006

ER -