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.