Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts

Background Whether healthy behaviors can attenuate the adverse association between ambient fine particulate matter (PM2.5) and cardiovascular disease (CVD) is inconclusive. METHODS AND RESULTS The parametric g‐formula was used to quantify the potential reduction in PM2.5 effect on CVD under differen...

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Main Authors: Jialong Wu, Liang Wang, Xu Han, Linya Huang, Qiong Meng, Tingting Yang, Quzong Deji, Zihao Wang, Bing Guo, Xing Zhao
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.038624
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author Jialong Wu
Liang Wang
Xu Han
Linya Huang
Qiong Meng
Tingting Yang
Quzong Deji
Zihao Wang
Bing Guo
Xing Zhao
author_facet Jialong Wu
Liang Wang
Xu Han
Linya Huang
Qiong Meng
Tingting Yang
Quzong Deji
Zihao Wang
Bing Guo
Xing Zhao
author_sort Jialong Wu
collection DOAJ
description Background Whether healthy behaviors can attenuate the adverse association between ambient fine particulate matter (PM2.5) and cardiovascular disease (CVD) is inconclusive. METHODS AND RESULTS The parametric g‐formula was used to quantify the potential reduction in PM2.5 effect on CVD under different scenarios of hypothetical behavioral interventions (including dietary patterns, physical activity, body mass index, alcohol consumption, smoking, and dietary supplements). Feasible intervention scenarios, defined on the basis of values considered feasible in previous real‐world interventions (eg, overweight participants lose 6.69% of their weight). Intensive scenarios, in which all participants are adopting completely healthy behaviors (eg, maintain normal weight). We also estimate the effect of joint interventions that incorporate the above behaviors. Long‐term PM2.5 exposure was associated with incident CVD in both cohorts, with the risk difference per 1000 person‐years for a 5 μg/m3 increase in PM2.5 being 1.42 (95% CI, 1.04–1.79) in the UKB (UK Biobank) and 2.15 (95% CI, 1.65–2.59) in the Sichuan Cohort (China Multi‐Ethnic Cohort, Sichuan Region). In both feasible and intensive scenarios, improving diet, physical activity, and body mass index could significantly reduce the risk difference of PM2.5 on CVD, with the reduced proportion ranging from 4.59% to 37.22%. A feasible joint hypothetical intervention on 6 behaviors would reduce the effect of PM2.5 on CVD by 31.47% (10.13%–57.26%) and 19.75% (10.78%–42.89%) in the low‐pollution UK Biobank and high‐pollution Sichuan cohort, respectively. A combination of more intensive interventions would reduce risk difference by 57.51% (21.64%–100.69%) and 45.54% (22.66%–106.66%), respectively. Conclusions Healthier behaviors could serve as individual‐level complementary strategies to emission control for minimizing the health impact of PM2.5, whether in high‐ or low‐pollution areas.
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spelling doaj-art-e14dc9f8235445cbbdf07cffdd9362802025-08-20T03:24:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.038624Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective CohortsJialong Wu0Liang Wang1Xu Han2Linya Huang3Qiong Meng4Tingting Yang5Quzong Deji6Zihao Wang7Bing Guo8Xing Zhao9West China School of Public Health and West China Fourth Hospital Sichuan University Chengdu Sichuan ChinaChengdu Center for Disease Control &Prevention Chengdu Sichuan ChinaHealth Information Center of Sichuan Province Chengdu Sichuan ChinaHealth Information Center of Sichuan Province Chengdu Sichuan ChinaDepartment of Epidemiology and Health Statistics, School of Public Health Kunming Medical University Kunming Yunnan ChinaSchool of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education Guizhou Medical University Guiyang ChinaTibet University Lhasa Tibet ChinaChongqing Municipal Center for Disease Control and Prevention Chongqing ChinaWest China School of Public Health and West China Fourth Hospital Sichuan University Chengdu Sichuan ChinaWest China School of Public Health and West China Fourth Hospital Sichuan University Chengdu Sichuan ChinaBackground Whether healthy behaviors can attenuate the adverse association between ambient fine particulate matter (PM2.5) and cardiovascular disease (CVD) is inconclusive. METHODS AND RESULTS The parametric g‐formula was used to quantify the potential reduction in PM2.5 effect on CVD under different scenarios of hypothetical behavioral interventions (including dietary patterns, physical activity, body mass index, alcohol consumption, smoking, and dietary supplements). Feasible intervention scenarios, defined on the basis of values considered feasible in previous real‐world interventions (eg, overweight participants lose 6.69% of their weight). Intensive scenarios, in which all participants are adopting completely healthy behaviors (eg, maintain normal weight). We also estimate the effect of joint interventions that incorporate the above behaviors. Long‐term PM2.5 exposure was associated with incident CVD in both cohorts, with the risk difference per 1000 person‐years for a 5 μg/m3 increase in PM2.5 being 1.42 (95% CI, 1.04–1.79) in the UKB (UK Biobank) and 2.15 (95% CI, 1.65–2.59) in the Sichuan Cohort (China Multi‐Ethnic Cohort, Sichuan Region). In both feasible and intensive scenarios, improving diet, physical activity, and body mass index could significantly reduce the risk difference of PM2.5 on CVD, with the reduced proportion ranging from 4.59% to 37.22%. A feasible joint hypothetical intervention on 6 behaviors would reduce the effect of PM2.5 on CVD by 31.47% (10.13%–57.26%) and 19.75% (10.78%–42.89%) in the low‐pollution UK Biobank and high‐pollution Sichuan cohort, respectively. A combination of more intensive interventions would reduce risk difference by 57.51% (21.64%–100.69%) and 45.54% (22.66%–106.66%), respectively. Conclusions Healthier behaviors could serve as individual‐level complementary strategies to emission control for minimizing the health impact of PM2.5, whether in high‐ or low‐pollution areas.https://www.ahajournals.org/doi/10.1161/JAHA.124.038624cardiovascular diseasesfine particulate matterg‐formulalifestyle
spellingShingle Jialong Wu
Liang Wang
Xu Han
Linya Huang
Qiong Meng
Tingting Yang
Quzong Deji
Zihao Wang
Bing Guo
Xing Zhao
Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular diseases
fine particulate matter
g‐formula
lifestyle
title Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
title_full Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
title_fullStr Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
title_full_unstemmed Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
title_short Hypothetical Behavioral Interventions for Mitigating the Cardiovascular Effects of Long‐Term Fine Particulate Matter Exposure: Analyses From 2 Prospective Cohorts
title_sort hypothetical behavioral interventions for mitigating the cardiovascular effects of long term fine particulate matter exposure analyses from 2 prospective cohorts
topic cardiovascular diseases
fine particulate matter
g‐formula
lifestyle
url https://www.ahajournals.org/doi/10.1161/JAHA.124.038624
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