Long-term exposure to particulate air pollution and presence and progression of carotid artery plaques - A northern Sweden VIPVIZA cohort study

Johan Nilsson Sommar; Margareta Norberg; Christer Grönlund; David Segersson; Ulf Näslund; Bertil Forsberg

doi:10.1016/j.envres.2022.113061

Long-term exposure to particulate air pollution and presence and progression of carotid artery plaques - A northern Sweden VIPVIZA cohort study

Environ Res. 2022 Aug:211:113061. doi: 10.1016/j.envres.2022.113061. Epub 2022 Mar 4.

Authors

Johan Nilsson Sommar¹, Margareta Norberg², Christer Grönlund³, David Segersson⁴, Ulf Näslund², Bertil Forsberg⁵

Affiliations

¹ Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Electronic address: johan.sommar@umu.se.
² Section of Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
³ Department of Radiation Sciences, Umeå University, Umeå, Sweden.
⁴ Swedish Meteorological and Hydrological Institute, Norrköping, Sweden.
⁵ Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

PMID: 35257687
DOI: 10.1016/j.envres.2022.113061

Abstract

Aims: To estimate the association between long-term exposure to particulate air pollution and sub-clinical atherosclerosis based on the existence of plaque and the carotid intima-media thickness (cIMT).

Methods: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a randomised controlled trial integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease (CVD) prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional CVD risk factors in Umeå municipality were eligible to participate. The 1425 participants underwent an ultrasound assessment of cIMT and plaque formation during the period 2013-2016 and at 3-year follow-up. Source-specific annual mean concentrations of particulate matter with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), and black carbon (BC) at the individual's residential address were modelled for the calendar years 1990, 2001 and 2011. Poisson regression was used to estimate prevalence ratios for presence of carotid artery plaques, and linear regression for cIMT.

Results: The plaque prevalence was 43% at baseline and 47% at follow-up. An interquartile range (IQR) increase in PM10 (range in year 2011: 7.1-13.5 μg/m³) was associated with a prevalence ratio at baseline ultrasound of 1.11 (95% CI 0.99-1.25), 1.08 (95% CI 0.99-1.17), and 1.00 (95% CI 0.93-1.08) for lag 23, 12 and 2 years, and at follow-up 1.04 (95% CI 0.95-1.14), 1.08 (95% CI 1.00-1.16), and 1.01 (95% CI 0.95-1.08). Similar prevalence ratios per IQR were found for PM2.5 and BC, but with somewhat lower precision for the later. Particle concentrations were however not associated with the progression of plaque. No cross-sectional or longitudinal associations of change were found for cIMT.

Conclusions: This study of individuals with low/moderate risk for CVD give some additional support for an effect of long-term air pollution in early subclinical atherosclerosis.

Keywords: Air pollution; Atherosclerosis; Carotid artery plaques; Carotid intima-media thickness; Cohort; Longitudinal.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Atherosclerosis* / chemically induced
Carotid Intima-Media Thickness
Carotid Stenosis* / chemically induced
Carotid Stenosis* / complications
Cohort Studies
Dust
Environmental Exposure / analysis
Humans
Particulate Matter / analysis
Plaque, Atherosclerotic* / chemically induced
Plaque, Atherosclerotic* / diagnostic imaging
Plaque, Atherosclerotic* / epidemiology
Sweden / epidemiology

Substances

Air Pollutants
Dust
Particulate Matter