Exposure to air pollutants and subclinical carotid atherosclerosis measured by magnetic resonance imaging: A cross-sectional analysis

PLoS One. 2024 Oct 31;19(10):e0309912. doi: 10.1371/journal.pone.0309912. eCollection 2024.

Abstract

Objectives: Long-term exposure to air pollution has been associated with higher risk of cardiovascular mortality. Less is known about the association of air pollution with initial development of cardiovascular disease. Herein, the association between low-level exposure to air pollutants and subclinical carotid atherosclerosis in adults without known clinical cardiovascular disease was investigated.

Design: Cross-sectional analysis within a prospective cohort study.

Setting: The Canadian Alliance for Healthy Hearts and Minds Cohort Study; a pan-Canadian cohort of cohorts.

Participants: Canadian adults (n = 6645) recruited between 2014-2018 from the provinces of British Columbia, Alberta, Ontario, Quebec, and Nova Scotia, were studied, for whom averages of exposures to nitrogen dioxide (NO2), ozone (O3), and fine particulate matter (PM2.5) were estimated for the years 2008-2012.

Main outcome measure: Carotid vessel wall volume (CWV) measured by magnetic resonance imaging (MRI).

Results: In adjusted linear mixed models, PM2.5 was not consistently associated with CWV (per 5 μg/m3 PM2.5; adjusted estimate = -8.4 mm3; 95% Confidence Intervals (CI) -23.3 to 6.48; p = 0.27). A 5 ppb higher NO2 concentration was associated with 11.8 mm3 lower CWV (95% CI -16.2 to -7.31; p<0.0001). A 3 ppb increase in O3 was associated with 9.34 mm3 higher CWV (95% CI 4.75 to 13.92; p<0.0001). However, the coarse/insufficient O3 resolution (10 km) is a limitation.

Conclusions: In a cohort of healthy Canadian adults there was no consistent association between PM2.5 or NO2 and increased CWV as a measure of subclinical atherosclerosis by MRI. The reasons for these inconsistent associations warrant further study.

MeSH terms

  • Adult
  • Aged
  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollutants* / toxicity
  • Air Pollution / adverse effects
  • Air Pollution / analysis
  • Canada / epidemiology
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / epidemiology
  • Carotid Artery Diseases* / etiology
  • Cross-Sectional Studies
  • Environmental Exposure / adverse effects
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Nitrogen Dioxide / adverse effects
  • Nitrogen Dioxide / analysis
  • Ozone* / adverse effects
  • Ozone* / analysis
  • Particulate Matter* / adverse effects
  • Particulate Matter* / analysis
  • Prospective Studies

Substances

  • Air Pollutants
  • Ozone
  • Particulate Matter
  • Nitrogen Dioxide

Grants and funding

CAHHM was funded by the Canadian Partnership Against Cancer (CPAC), Heart and Stroke Foundation of Canada (HSF-Canada), and the Canadian Institutes of Health Research (CIHR). Financial contributions were also received from the Population Health Research Institute and CIHR Foundation Grant no. FDN-143255 to S.S.A.; FDN-143313 to J.V.T.; and FDN 154317 to E.E.S. In-kind contributions from A.R.M. and S.E.B. from Sunnybrook Hospital, Toronto for MRI reading costs, and Bayer AG for provision of IV contrast. The Canadian Partnership for Tomorrow’s Health is funded by the Canadian Partnership Against Cancer and Health Canada, BC Cancer, Genome Quebec, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Dalhousie University, Ontario Institute for Cancer Research, Alberta Health, Alberta Cancer Foundation, and Alberta Health Services. The PURE Study was funded by multiple sources. The Montreal Heart Institute Biobank is funded by Mr André Desmarais and Mrs France Chrétien-Desmarais and the Montreal Heart Institute Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.