Key result
Long-term PM2.5 exposure linked to ~0.3-point lower flow-mediated dilation per 3-μg/m3 increase.
Why the study?
Long-term effects of PM2.5 exposure on endothelial dysfunction have not been investigated despite known links between air pollution and cardiovascular mortality.
Does long-term and short-term exposure to ambient PM 2.5 reduce flow-mediated dilation in adults free of clinical cardiovascular disease?
Cross-Sectional (n=3,040)
Yes
Does long-term and short-term exposure to ambient PM 2.5 reduce flow-mediated dilation in adults free of clinical cardiovascular disease?
Mean Difference: -0.3 (95% CI -0.6–-0.03)
p-value: p=0.03
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Long-term [fine particulate matter] exposure was significantly associated with decreased endothelial function according to brachial ultrasound results. These findings may elucidate an important pathway linking air pollution and cardiovascular mortality.”
Long-term residential exposure to fine particulate matter (PM 2.5) is significantly associated with reduced NO-mediated endothelial function, suggesting a mechanism by which air pollution increases cardiovascular risk.
Objectives This study evaluated the association of long- and short-term air pollutant exposures with flow-mediated dilation (FMD) and baseline arterial diameter (BAD) of the brachial artery using ultrasound in a large multicity cohort. Background Exposures to ambient air pollution, especially long-term exposure to particulate matter <2.5 μm in aerodynamic diameter (PM2.5), are linked with cardiovascular mortality. Short-term exposure to PM2.5 has been associated with decreased FMD and vasoconstriction, suggesting that adverse effects of PM2.5 may involve endothelial dysfunction. However, long-term effects of PM2.5 on endothelial dysfunction have not been investigated. Methods FMD and BAD were measured by brachial artery ultrasound at the initial examination of the Multi-Ethnic Study of Atherosclerosis. Long-term PM2.5 concentrations were estimated for the year 2000 at each participant’s residence (n = 3,040) using a spatio-temporal model informed by cohort-specific monitoring. Short-term PM2.5 concentrations were based on daily central-site monitoring in each of the 6 cities. Results An interquartile increase in long-term PM2.5 concentration (3 μg/m3) was associated with a 0.3% decrease in FMD (95% confidence interval [CI] of difference: −0.6 to −0.03; p = 0.03), adjusting for demographic characteristics, traditional risk factors, sonographers, and 1/BAD. Women, nonsmokers, younger participants, and those with hypertension seemed to show a greater association of PM2.5 with FMD. FMD was not significantly associated with short-term variation in PM2.5 (−0.1% per 12 μg/m3 daily increase [95% CI: −0.2 to 0.04] on the day before examination). Conclusions Long-term PM2.5 exposure was significantly associated with decreased endothelial function according to brachial ultrasound results. These findings may elucidate an important pathway linking air pollution and cardiovascular mortality.
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Krishnan et al. (2012) conducted a cross-sectional in Subclinical atherosclerosis (n=3,040). Long-term exposure to fine particulate matter (PM 2.5) vs. Lower exposure levels was evaluated on Flow-mediated dilation (FMD%) decrease per 3-μg/m3 increase in annual average PM 2.5 (MD -0.3, 95% CI -0.6 to -0.03, p=0.03). Long-term exposure to fine particulate matter (PM 2.5) decreased flow-mediated dilation by 0.3% per 3-μg/m3 increase, indicating worsened endothelial dysfunction.
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