What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular events (n=6444441). Intervention: Ambient ozone pollution vs. Lower ozone concentrations. Primary outcome: Hospital admissions for coronary heart disease (0.46% risk increase per 10 μg/m3 increment, 95% CI 0.28-0.64).

What does this research mean for the field?

Ambient ozone pollution is associated with an increased risk of hospital admissions for cardiovascular events, particularly on days with high ozone levels. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the acute associations between ambient ozone pollution exposure and hospital admission risks across a wide range of cardiovascular events.

April 20, 2026European Heart JournalOpen Access

Ozone pollution and hospital admissions for cardiovascular events

Q: What are the key findings of this study?

Ambient ozone exposure was associated with increased cardiovascular hospital admissions, including a 0.46% (95% CI 0.28-0.64%) risk increase for coronary heart disease per 10 μg/m3 increment.

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Key result

Ambient ozone exposure linked to ~0.5% higher coronary heart disease admissions per 10 μg/m3 increment.

0.46% risk increase per 10 μg/m3 increment
95% CI 0.28-0.64
n=6,444,441

Why the study?

The available literature on morbidity risk of cardiovascular diseases associated with ambient ozone pollution is still limited.

Does exposure to ambient ozone pollution increase the risk of hospital admissions for cardiovascular events?

Population

6,444,441 daily hospital admissions for cardiovascular events in 70 Chinese cities during 2015-17

Comparison

High ozone pollution days (≥100 µg/m3) vs lower ozone pollution days (<70 µg/m3)

Design

Two-stage multi-city time-series observational study

Authors

YJYunxing JiangUniversity of Occupational and Environmental Health Japan JHJing Huang GLGuoxing LiHubei University of Medicine

Discussion

Member takes

Implication

May support advising CV patients to limit exposure on high-ozone days; leaves open whether reducing exposure lowers admissions.

Key Points

To evaluate the acute associations between ambient ozone pollution exposure and hospital admission risks across a wide range of cardiovascular events.
Conducted a two-stage multi-city time-series analysis evaluating daily hospital admissions (n = 6,444,441) across 70 prefecture-level or above cities in China from 2015 to 2017.
Estimated excess admission risks associated with each 10 μg/m3 increment in 2-day average daily 8-hour maximum ozone levels and compared high pollution days (≥100 µg/m3) to lower exposure days (<70 µg/m3).
A 10 μg/m3 rise in ozone was associated with admission risk increases of 0.75% (95% CI: 0.38%, 1.13%) for acute myocardial infarction, 0.70% (95% CI: 0.41%, 1.00%) for acute coronary syndrome, and 0.50% (95% CI: 0.24%, 0.77%) for heart failure.
Admissions also rose for coronary heart disease (0.46%, 95% CI: 0.28%, 0.64%), angina pectoris (0.45%, 95% CI: 0.13%, 0.77%), stroke (0.40%, 95% CI: 0.23%, 0.58%), and ischemic stroke (0.41%, 95% CI: 0.22%, 0.60%).
High ozone pollution days (≥100 µg/m3 vs. <70 µg/m3) exhibited excess admission risks ranging from 3.38% (95% CI: 1.73%, 5.06%) for stroke to 6.52% (95% CI: 2.92%, 10.24%) for acute myocardial infarction.

Study Design

Type

Observational (n=6,444,441)

Multicenter

Yes

Structured PICO

Does exposure to ambient ozone pollution increase the risk of hospital admissions for cardiovascular events?

Population

6,444,441 daily hospital admissions for cardiovascular events across 70 Chinese cities evaluated between 2015 and 2017.

Exposure

Exposure to ambient ozone pollution (evaluated as 10 μg/m3 increment in 2-day average daily 8 h maximum ozone concentrations and high ozone pollution days ≥100 µg/m3)

Comparator

Lower ozone pollution days (< 70 µg/m3)

Outcome

Daily hospital admissions for cardiovascular events (including coronary heart disease, angina pectoris, acute myocardial infarction, acute coronary syndrome, heart failure, stroke, and ischemic stroke)hard clinical

Main Result

Effect estimate: 0.46% risk increase per 10 μg/m3 increment (95% CI 0.28-0.64)

Ambient ozone pollution is associated with a significantly increased risk of hospital admissions for various cardiovascular events, highlighting the need for environmental control measures.

Cite This Study

Jiang et al. (2023) conducted an observational in Cardiovascular events (n=6,444,441). Ambient ozone pollution vs. Lower ozone concentrations was evaluated on Hospital admissions for coronary heart disease (0.46% risk increase per 10 μg/m3 increment, 95% CI 0.28-0.64). Ambient ozone exposure was associated with increased cardiovascular hospital admissions, including a 0.46% (95% CI 0.28-0.64%) risk increase for coronary heart disease per 10 μg/m3 increment.

synapsesocial.com/papers/69e643eac3fdccbe27a8aa76 https://doi.org/10.1093/eurheartj/ehad091

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Ozone pollution and hospital admissions for cardiovascular events

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Ozone pollution and hospital admissions for cardiovascular events

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider