Association Between Long-Term Ambient Noise Exposure and Coronary Artery Calcification in a Health Examination Population

Objective: This study aims to investigate the association between long-term ambient noise exposure and coronary artery calcium (CAC) in a health examination population. Methods: A total of 613 individuals who underwent health examinations between January 2022 and June 2025 were enrolled. Participants were categorized into low-noise (<55 dB), moderate-noise (55–65 dB), and high-noise (≥65 dB) exposure groups. Clinical data were collected. The relationship between noise exposure and CAC was analyzed by using multivariable logistic and linear regression models. Results: The CAC detection rate significantly increased with increasing noise exposure levels ( P for trend <0.05). Multivariable linear regression analysis, after full adjustment for potential confounders (Model 3), revealed that compared with the low-exposure group, the moderate- and high-exposure groups had a significantly higher CAC score, with mean increases of 9.85 and 35.27 points, respectively (both P < 0.001). Furthermore, for every 10 dB increase in noise exposure levels, the high-exposure groups had 1.52- and 1.72-fold higher risks, respectively, than the low-exposure group (both P < 0.001). Additionally, for every 10 dB increase in nighttime noise levels, the risk of CAC positivity increased by 17% ( P < 0.001). Subgroup analyses demonstrated that the positive association between noise exposure and the CAC score was more pronounced among males, individuals aged ≥60 years, smokers, and those with hypertension or diabetes (all P for interaction <0.05) than in other patients. Conclusion: Long-term ambient noise exposure is independently associated with an elevated CAC score and an increased prevalence of CAC positivity, with nighttime exposure showing a notable association. Specific populations may be highly vulnerable.