Cardiovascular diseases burden attributable to ambient PM2.5 pollution from 1990 to 2019: A systematic analysis for the global burden of disease study 2019

Background: Ambient PM2.5 pollution (APMP(2.5)) was the leading environmental risk factor for cardiovascular diseases (CVDs) worldwide. An up-to-date comprehensive study is needed to provide global epidemiological patterns.Methods: Detailed data on CVDs burden attributable to APMP(2.5) were obtained from the Global Burden of Disease Study (GBD) 2019. We calculated the estimated annual percentage change (EAPC) to assess temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years.Results: Globally, CVDs attributable to APMP(2.5) resulted in 2.48 million deaths and 60.91 million DALYs, with an increase of 122%, respectively from 1990 to 2019. In general, men suffered markedly higher burden than women, but the gap will likely turn narrow. As for age distribution, CVDs deaths and DALYs attributable to APMP(2.5) mainly occurred in the elder group (>70 years). Low- and middle-income regions endured the higher CVDs burden due to the higher exposure to APMP(2.5), and the gap may potentially expand further compared with high-income regions. For regions, the highest age-standardized rates of APMP(2.5)-related CVDs deaths and DALYs were observed mainly in Central Asia, while the lowest was observed in Australasia. At the national level, countries with the largest ASDR decline were clustered in western Europe, while Equatorial Guinea, Timor-Leste and Bhutan exhibited relatively rapid increases over this period.Conclusions: The global CVDs burden attributable to APMP(2.5) has contributed to the heterogeneity of spatial and temporal distribution. APMP(2.5)-related CVDs deaths have largely shifted from higher SDI regions to those with a lower SDI. Globally, APMP(2.5)-attributable CVDs pose a significant threat to public health and diseases burden has increased over time, particularly in male, old-aged populations. The governments and health systems should take measures to reduce air pollution to impede this rising trend.