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Journal article
Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study
The Lancet (British edition), v 388(10045), pp 696-704
13 Aug 2016
PMCID: PMC5019949
PMID: 27233746
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Long-term exposure to fine particulate matter less than 2.5 μm in diameter (PM2.5) and traffic-related air pollutant concentrations are associated with cardiovascular risk. The disease process underlying these associations remains uncertain. We aim to assess association between long-term exposure to ambient air pollution and progression of coronary artery calcium and common carotid artery intima-media thickness.
In this prospective 10-year cohort study, we repeatedly measured coronary artery calcium by CT in 6795 participants aged 45-84 years enrolled in the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) in six metropolitan areas in the USA. Repeated scans were done for nearly all participants between 2002 and 2005, for a subset of participants between 2005 and 2007, and for half of all participants between 2010 and 2012. Common carotid artery intima-media thickness was measured by ultrasound in all participants at baseline and in 2010-12 for 3459 participants. Residence-specific spatio-temporal pollution concentration models, incorporating community-specific measurements, agency monitoring data, and geographical predictors, estimated concentrations of PM2.5 and nitrogen oxides (NOX) between 1999 and 2012. The primary aim was to examine the association between both progression of coronary artery calcium and mean carotid artery intima-media thickness and long-term exposure to ambient air pollutant concentrations (PM2.5, NOX, and black carbon) between examinations and within the six metropolitan areas, adjusting for baseline age, sex, ethnicity, socioeconomic characteristics, cardiovascular risk factors, site, and CT scanner technology.
In this population, coronary calcium increased on average by 24 Agatston units per year (SD 58), and intima-media thickness by 12 μm per year (10), before adjusting for risk factors or air pollutant exposures. Participant-specific pollutant concentrations averaged over the years 2000-10 ranged from 9.2-22.6 μg PM2.5/m(3) and 7.2-139.2 parts per billion (ppb) NOX. For each 5 μg PM2.5/m(3) increase, coronary calcium progressed by 4.1 Agatston units per year (95% CI 1.4-6.8) and for each 40 ppb NOX coronary calcium progressed by 4.8 Agatston units per year (0.9-8.7). Pollutant exposures were not associated with intima-media thickness change. The estimate for the effect of a 5 μg/m(3) higher long-term exposure to PM2.5 in intima-media thickness was -0.9 μm per year (95% CI -3.0 to 1.3). For 40 ppb higher NOX, the estimate was 0.2 μm per year (-1.9 to 2.4).
Increased concentrations of PM2.5 and traffic-related air pollution within metropolitan areas, in ranges commonly encountered worldwide, are associated with progression in coronary calcification, consistent with acceleration of atherosclerosis. This study supports the case for global efforts of pollution reduction in prevention of cardiovascular diseases.
US Environmental Protection Agency and US National Institutes of Health.
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Details
- Title
- Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study
- Creators
- Joel D Kaufman - University of WashingtonSara D Adar - University of Michigan–Ann ArborR Graham Barr - Columbia UniversityMatthew Budoff - Los Angeles Biomedical Research InstituteGregory L Burke - Wake Forest UniversityCynthia L Curl - Boise State UniversityMartha L Daviglus - Northwestern UniversityAna V Diez Roux - Drexel UniversityAmanda J Gassett - University of WashingtonDavid R Jacobs, Jr - School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USARichard Kronmal - University of WashingtonTimothy V Larson - University of WashingtonAna Navas-Acien - Johns Hopkins UniversityCasey Olives - University of WashingtonPaul D Sampson - University of WashingtonLianne Sheppard - University of WashingtonDavid S Siscovick - University of WashingtonJames H Stein - University of Wisconsin–MadisonAdam A Szpiro - University of WashingtonKarol E Watson - University of California, Los Angeles
- Publication Details
- The Lancet (British edition), v 388(10045), pp 696-704
- Publisher
- Elsevier
- Grant note
- N01HC95169 / NHLBI NIH HHS N01 HC095160 / NHLBI NIH HHS UL1-TR-000040 / NCATS NIH HHS N01HC95161 / NHLBI NIH HHS P30 ES009089 / NIEHS NIH HHS N01HC95164 / NHLBI NIH HHS N01 HC095165 / NHLBI NIH HHS P50 ES015915 / NIEHS NIH HHS N01-HC-95169 / NHLBI NIH HHS N01HC95167 / NHLBI NIH HHS N01 HC095162 / NHLBI NIH HHS N01HC95159 / NHLBI NIH HHS N01-HC-95166 / NHLBI NIH HHS N01HC95163 / NHLBI NIH HHS N01 HC095166 / NHLBI NIH HHS N01 HC095163 / NHLBI NIH HHS N01HC95166 / NHLBI NIH HHS N01-HC-95163 / NHLBI NIH HHS P30ES07033 / NIEHS NIH HHS UL1 TR001079 / NCATS NIH HHS K24 ES013195 / NIEHS NIH HHS N01 HC095164 / NHLBI NIH HHS N01-HC-95168 / NHLBI NIH HHS N01-HC-95165 / NHLBI NIH HHS K24ES013195 / NIEHS NIH HHS N01-HC-95160 / NHLBI NIH HHS P50ES015915 / NIEHS NIH HHS N01 HC095169 / NHLBI NIH HHS N01HC95160 / NHLBI NIH HHS N01-HC-95162 / NHLBI NIH HHS UL1-TR-001079 / NCATS NIH HHS N01-HC-95159 / NHLBI NIH HHS N01 HC095159 / NHLBI NIH HHS N01 HC095161 / NHLBI NIH HHS N01HC95168 / NHLBI NIH HHS UL1 TR000040 / NCATS NIH HHS N01-HC-95161 / NHLBI NIH HHS N01-HC-95167 / NHLBI NIH HHS N01-HC-95164 / NHLBI NIH HHS N01HC95165 / NHLBI NIH HHS P30 ES007033 / NIEHS NIH HHS N01 HC095167 / NHLBI NIH HHS N01HC95162 / NHLBI NIH HHS UL1 TR001420 / NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000381268700029
- Scopus ID
- 2-s2.0-84973447823
- Other Identifier
- 991019168979704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems