Association between long-term exposure to air pollutants and prevalence of cardiovascular disease in 108 South Korean communities in 2008-2010: A cross-sectional study

Air pollution has been linked to cardiovascular disease, which is the leading cause of death worldwide. The aim of this study was to evaluate the epidemiological association between the yearly concentration of air pollution and regional prevalence of cardiovascular disease in South Korea. In this cross-sectional study, data regarding the regional prevalence of cardiovascular disease (i.e., hypertension, stroke, myocardial infarction, and angina) and health behaviors were obtained from the Korean Community Health Survey conducted in 108 communities of South Korea in 2008-2010. Data on carbon monoxide (CO; ppb), nitrogen dioxide (NO2; ppb), and particulate matter up to 10 mu m in size (PM10; mu g/m(3)) were collected from the National Institute of Environmental Research. We used a distributed lag model with generalized estimating equations to represent the corrected lag-response and correlation among repeated observations. Cumulative odds ratios of hypertension, hypertension in those aged >30 years, stroke, and angina with an increase of 10 mu g/m(3) in PM10 were 1.042 (95% confidence interval [CI]: 1.009, 1.077), 1.044 (CI: 1.009, 1.079), 1.044 (CI: 0.979, 1.114), and 0.977 (CI: 0.901, 1.059), respectively; a 10 ppb increase in NO2 was associated with an odds ratio of 1.077 (CI: 1.044, 1.112), 1.08 (CI: 1.043, 1.118), 1.073 (CI: 0.994, 1.157), and 1.047 (CI: 0.968, 1.134), respectively. A 10 ppb increase in CO was associated with an odds ratio of 1.123 (CI: 0.963, 1.31), 1.129 (CI: 0.963, 1.387), and 1.336 (CI: 0.9887, 2.011) for hypertension, hypertension in patients >30 years, and stroke >50, respectively. We found suggestive evidence of an association between the long-term (ex)posure (i.e., delayed for 5 years) to air pollutants (i.e., PM10, NO2, and CO) and the regional prevalence of chronic cardiovascular disease (i.e., hypertension, stroke, myocardial infarction, and angina) in 108 communities in South Korea. (C) 2016 Elsevier B.V. All rights reserved.