Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank

Abstract Background Evidence on active commuting and heart failure (HF) under levels of air pollution exposure is limited, and little is known on the potential mediation roles of inflammation. The objective of this study was to investigate the association between active commuting and HF, as well as...

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Main Authors: Qian Sun, Chaojun Yang, Min Jiang, Mudan Yang, Menglu Mao, Zhixing Fan
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22111-w
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author Qian Sun
Chaojun Yang
Min Jiang
Mudan Yang
Menglu Mao
Zhixing Fan
author_facet Qian Sun
Chaojun Yang
Min Jiang
Mudan Yang
Menglu Mao
Zhixing Fan
author_sort Qian Sun
collection DOAJ
description Abstract Background Evidence on active commuting and heart failure (HF) under levels of air pollution exposure is limited, and little is known on the potential mediation roles of inflammation. The objective of this study was to investigate the association between active commuting and HF, as well as to ascertain whether air pollution may influence this relationship. Methods This prospective study included 241,786 participants without HF at baseline in UK Biobank. The commuting mode was recorded using questionnaire. We examined long-term exposure to air pollution, including particulate matter with an aerodynamic diameter smaller than 2.5 μm (PM2.5) or 10 μm (PM10), PM2.5–10, nitrogen dioxide (NO2), and nitrogen oxide (NOx). The incident HF was identified through linkages with medical records. Cox proportional hazard models were used to estimate the association of active commuting on HF under different air pollution concentrations. Furthermore, mediation analysis was performed to test the mediated role of inflammation. Results A median follow-up period of 13.7 years yielded 4485 incident cases of HF. Compared with non-active commuting, both cycling (HR = 0.66, 95%CI: 0.57–0.76) and walking mode (HR = 0.86, 95%CI: 0.78–0.94) were found to be associated with the reduced risk of HF, following the full adjustment for covariates, including PM2.5. The beneficial effect of cycling (HR = 0.68, 95%CI: 0.56–0.81) and walking mode (HR = 0.82, 95%CI: 0.72–0.92) on HF was also observed in the context of high PM2.5 exposure. The inflammatory response was responsible for mediating 21.97% and 13.83% of the effect of the association between cycling mode and walking mode and HF. Conclusions For those residing in regions with relatively elevated air pollution levels, active commuting may still be a viable strategy for the prevention of HF.
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spelling doaj-art-bd171f259c8b4048a3e6655ec55f93312025-08-20T03:03:51ZengBMCBMC Public Health1471-24582025-03-0125111110.1186/s12889-025-22111-wAmbient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK BiobankQian Sun0Chaojun Yang1Min Jiang2Mudan Yang3Menglu Mao4Zhixing Fan5Department of Clinical Laboratory, The Affiliated LiHuiLi Hospital of Ningbo UniversityInstitute of Cardiovascular Diseases, China Three Gorges UniversityDepartment of Clinical Laboratory, The Affiliated LiHuiLi Hospital of Ningbo UniversityDepartment of Clinical Laboratory, The Affiliated LiHuiLi Hospital of Ningbo UniversityDepartment of Clinical Laboratory, The Affiliated LiHuiLi Hospital of Ningbo UniversityInstitute of Cardiovascular Diseases, China Three Gorges UniversityAbstract Background Evidence on active commuting and heart failure (HF) under levels of air pollution exposure is limited, and little is known on the potential mediation roles of inflammation. The objective of this study was to investigate the association between active commuting and HF, as well as to ascertain whether air pollution may influence this relationship. Methods This prospective study included 241,786 participants without HF at baseline in UK Biobank. The commuting mode was recorded using questionnaire. We examined long-term exposure to air pollution, including particulate matter with an aerodynamic diameter smaller than 2.5 μm (PM2.5) or 10 μm (PM10), PM2.5–10, nitrogen dioxide (NO2), and nitrogen oxide (NOx). The incident HF was identified through linkages with medical records. Cox proportional hazard models were used to estimate the association of active commuting on HF under different air pollution concentrations. Furthermore, mediation analysis was performed to test the mediated role of inflammation. Results A median follow-up period of 13.7 years yielded 4485 incident cases of HF. Compared with non-active commuting, both cycling (HR = 0.66, 95%CI: 0.57–0.76) and walking mode (HR = 0.86, 95%CI: 0.78–0.94) were found to be associated with the reduced risk of HF, following the full adjustment for covariates, including PM2.5. The beneficial effect of cycling (HR = 0.68, 95%CI: 0.56–0.81) and walking mode (HR = 0.82, 95%CI: 0.72–0.92) on HF was also observed in the context of high PM2.5 exposure. The inflammatory response was responsible for mediating 21.97% and 13.83% of the effect of the association between cycling mode and walking mode and HF. Conclusions For those residing in regions with relatively elevated air pollution levels, active commuting may still be a viable strategy for the prevention of HF.https://doi.org/10.1186/s12889-025-22111-wActive commutingPM2.5Heart failureCyclingWalkingInflammation
spellingShingle Qian Sun
Chaojun Yang
Min Jiang
Mudan Yang
Menglu Mao
Zhixing Fan
Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
BMC Public Health
Active commuting
PM2.5
Heart failure
Cycling
Walking
Inflammation
title Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
title_full Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
title_fullStr Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
title_full_unstemmed Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
title_short Ambient air pollution does not diminish the beneficial effects of active commuting on heart failure: a prospective study in UK Biobank
title_sort ambient air pollution does not diminish the beneficial effects of active commuting on heart failure a prospective study in uk biobank
topic Active commuting
PM2.5
Heart failure
Cycling
Walking
Inflammation
url https://doi.org/10.1186/s12889-025-22111-w
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