Association Between Long-Term Aircraft Noise Exposure and Cardiovascular Disease: A Meta-Analysis with Focused Subgroup Analyses

Abstract Background Aircraft noise is a growing public health concern, particularly for those living near airports. Our study aimed to evaluate the long-term impact of aircraft noise exposure on cardiovascular health outcomes. Methods We conducted a comprehensive search of multiple databases up to December 2024. Statistical analysis was performed using RevMan 5.4 with a random-effects model, pooling outcomes as odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). The study protocol was preregistered in PROSPERO (CRD42024598651). Results Our meta-analysis included 34 studies with a combined sample of approximately 35.5 million adults aged 18 years and older, with follow-up durations ranging from 1 to 20 years. Pooled analysis revealed a statistically significant association between aircraft noise exposure and the risk of cardiovascular disease (CVD), with an OR of 1.1 (95% CI: 1.07 to 1.14, p 0.001). Subgroup analysis of nighttime exposure showed a stronger association, with a significant increase in CVD risk (OR = 1.14, 95% CI: 1.04 to 1.26, p = 0.006). Additionally, a significant association was found between aircraft noise exposure and overall CVD mortality, with an OR of 1.07 (95% CI: 1.01 to 1.13, p = 0.02). Although the association appeared stronger in females, this sex-specific difference was not statistically significant. Mortality related to myocardial infarction (MI) was also significantly associated with aircraft noise exposure, with an OR of 1.07 (95% CI: 1.02 to 1.12, p = 0.009). However, no significant increase in mortality was observed for ischemic heart disease (IHD) or stroke, with ORs of 1.05 (p = 0.08) and 1.01 (p = 0.3), respectively. Additionally, aircraft noise exposure was associated with a significantly higher risk of hypertension in males (OR = 1.42) compared to females (OR = 1.01). While the overall association with hypertension was not statistically significant (OR = 1.02; p = 0.74), aircraft noise exposure was linked to a significant increase in systolic blood pressure (MD = 1.83 mmHg; p = 0.04), highlighting a potential early impact on cardiovascular risk. Conclusion Our study demonstrates a significant association between aircraft noise exposure and increased risk of cardiovascular events and mortality, with stronger association during nighttime exposure. The observed increase in systolic blood pressure and higher hypertension risk in males suggest early and sex-specific cardiovascular effects. These findings highlight the importance of mitigating chronic aircraft noise exposure to reduce its long-term cardiovascular burden.