Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study
IntroductionCoronary heart disease (CHD) is a leading cause of cardiovascular mortality, with air pollution serving as a significant risk factor. Henan Province, characterized by both a high incidence of CHD and severe air pollution, faces substantial health and economic challenges. However, limited...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1538788/full |
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| author | Shuming Liu Yongbin Wang Lujie Wang Xuefang Li Menghui Fei Pingshuan Dong Kan Yang Hui Liu Na Xie Hengwen Chen Guang Chen Huan Li Xiayan Zang Jun Li Zhigang Chen Fei Lin Fei Lin Guoan Zhao Guoan Zhao |
| author_facet | Shuming Liu Yongbin Wang Lujie Wang Xuefang Li Menghui Fei Pingshuan Dong Kan Yang Hui Liu Na Xie Hengwen Chen Guang Chen Huan Li Xiayan Zang Jun Li Zhigang Chen Fei Lin Fei Lin Guoan Zhao Guoan Zhao |
| author_sort | Shuming Liu |
| collection | DOAJ |
| description | IntroductionCoronary heart disease (CHD) is a leading cause of cardiovascular mortality, with air pollution serving as a significant risk factor. Henan Province, characterized by both a high incidence of CHD and severe air pollution, faces substantial health and economic challenges. However, limited research has explored the relationship between air pollution and CHD in this region.MethodsThis study employs a case-crossover design combined with a distributed lag non-linear model (DLNM) to examine the short-term effects of extreme concentrations of air pollutants (PM₂.₅, PM₁₀, NO₂, SO₂, CO, and O₃) on CHD hospitalizations in Henan. Data on 133,294 confirmed CHD patients from seven large hospitals across five cities (2016–2021) were collected, with patients' addresses linked to nearby air quality monitoring stations to assess exposure to air pollutants and meteorological factors. The time-stratified case-crossover design and DLNM were used to calculate relative risks (RRs) for pollutant exposure on CHD hospitalizations, and subgroup analyses were conducted to identify sensitive groups.ResultsSignificant increases in CHD hospitalizations were associated with extremely high concentrations of NO₂, SO₂, and PM₁₀, with maximum RRs of 1.768 for NO₂, 2.821 for SO₂, and 1.728 for PM₁₀ on the 7th cumulative day, while high O₃ levels showed a protective effect. Younger individuals (≤64y) and males were more sensitive to these effects, and high CO concentrations only increase the risk of CHD incidence in the younger (≤64y) subgroup. Synergistic interactions were observed between certain pollutants, such as CO and NO₂/SO₂/PM₁₀, suggesting that the negative impact of CO on CHD is amplified in a multi-pollutant environment due to interactions with other pollutants.DiscussionThese findings highlight the significant public health impact of air pollution on CHD in Henan Province. |
| format | Article |
| id | doaj-art-709eeffef2cd4513bd0d2bb1b354747d |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-04-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-709eeffef2cd4513bd0d2bb1b354747d2025-08-20T02:24:49ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-04-011210.3389/fcvm.2025.15387881538788Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover studyShuming Liu0Yongbin Wang1Lujie Wang2Xuefang Li3Menghui Fei4Pingshuan Dong5Kan Yang6Hui Liu7Na Xie8Hengwen Chen9Guang Chen10Huan Li11Xiayan Zang12Jun Li13Zhigang Chen14Fei Lin15Fei Lin16Guoan Zhao17Guoan Zhao18Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaDepartment of Epidemiology and Health Statistics, Xinxiang Medical University, Xinxiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaHenan Engineering Technology Research Center of Environmental Meteorological Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaDepartment of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaDepartment of Cardiology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, ChinaDepartment of Cardiology, Nanyang Central Hospital, Nanyang, ChinaDepartment of Cardiology, Anyang District Hospital, Anyang, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, ChinaGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaLi Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaHenan Engineering Technology Research Center of Environmental Meteorological Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaHenan Engineering Technology Research Center of Environmental Meteorological Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaHenan Engineering Technology Research Center of Environmental Meteorological Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui, China0Department of traditional Chinese medicine, The First Affliated Hospital of Xinxiang Medical University, Weihui, ChinaDepartment of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaHenan Engineering Technology Research Center of Environmental Meteorological Medicine, The First Affiliated Hospital of Xinxiang Medical University, Weihui, ChinaIntroductionCoronary heart disease (CHD) is a leading cause of cardiovascular mortality, with air pollution serving as a significant risk factor. Henan Province, characterized by both a high incidence of CHD and severe air pollution, faces substantial health and economic challenges. However, limited research has explored the relationship between air pollution and CHD in this region.MethodsThis study employs a case-crossover design combined with a distributed lag non-linear model (DLNM) to examine the short-term effects of extreme concentrations of air pollutants (PM₂.₅, PM₁₀, NO₂, SO₂, CO, and O₃) on CHD hospitalizations in Henan. Data on 133,294 confirmed CHD patients from seven large hospitals across five cities (2016–2021) were collected, with patients' addresses linked to nearby air quality monitoring stations to assess exposure to air pollutants and meteorological factors. The time-stratified case-crossover design and DLNM were used to calculate relative risks (RRs) for pollutant exposure on CHD hospitalizations, and subgroup analyses were conducted to identify sensitive groups.ResultsSignificant increases in CHD hospitalizations were associated with extremely high concentrations of NO₂, SO₂, and PM₁₀, with maximum RRs of 1.768 for NO₂, 2.821 for SO₂, and 1.728 for PM₁₀ on the 7th cumulative day, while high O₃ levels showed a protective effect. Younger individuals (≤64y) and males were more sensitive to these effects, and high CO concentrations only increase the risk of CHD incidence in the younger (≤64y) subgroup. Synergistic interactions were observed between certain pollutants, such as CO and NO₂/SO₂/PM₁₀, suggesting that the negative impact of CO on CHD is amplified in a multi-pollutant environment due to interactions with other pollutants.DiscussionThese findings highlight the significant public health impact of air pollution on CHD in Henan Province.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1538788/fullair pollutioncoronary heart diseasedistributed lag nonlinear modeltime-stratified case-crossover designinteractionHenan province |
| spellingShingle | Shuming Liu Yongbin Wang Lujie Wang Xuefang Li Menghui Fei Pingshuan Dong Kan Yang Hui Liu Na Xie Hengwen Chen Guang Chen Huan Li Xiayan Zang Jun Li Zhigang Chen Fei Lin Fei Lin Guoan Zhao Guoan Zhao Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study Frontiers in Cardiovascular Medicine air pollution coronary heart disease distributed lag nonlinear model time-stratified case-crossover design interaction Henan province |
| title | Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study |
| title_full | Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study |
| title_fullStr | Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study |
| title_full_unstemmed | Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study |
| title_short | Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study |
| title_sort | short term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in henan province a time stratified case crossover study |
| topic | air pollution coronary heart disease distributed lag nonlinear model time-stratified case-crossover design interaction Henan province |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1538788/full |
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