Investigation of air pollution and noise on progression of thoracic aortic calcification: results of the Heinz Nixdorf Recall Study

Abstract

Aims Air pollution and noise are potential risk factors for subclinical atherosclerosis. Longitudinal analyses, especially on the interplay of these environmental factors, are scarce and inconsistent. Hence we investigated long-term traffic-related exposure to air pollution and noise with the development and progression of thoracic aortic calcification, a marker of subclinical atherosclerosis. Methods We used baseline (2000–2003) and follow-up (2006–2008) data from the German Heinz Nixdorf Recall cohort study, including 4814 middle-aged adults. Residence-based air pollution (PM2.5 (aerodynamic diameter ≤ 2.5 µm), PM10, nitrogen dioxide and particle number), and noise was assessed with dispersion models. Thoracic aortic calcification was quantified from non-contrast enhanced electron beam computed tomography. The presence and extent of thoracic aortic calcification progression were analysed with multiple logistic and linear regression models, respectively, adjusting for age, sex, lifestyle variables, socioeconomic status and respective co-exposure. Results We observed no association in the full study sample ( n = 3155, mean age 59.1 (±7.6) years, 52.8% women). While an interquartile range in particle number and night-time noise yielded odds ratios of 1.20 (1.03, 1.40) and 1.21 (1.00, 1.46) for binary thoracic aortic calcification progression, and 0.02 (–0.01, 0.05) and 0.04 (0.00, 0.07) higher growth rates of thoracic aortic calcification in participants with baseline thoracic aortic calcification less than 10, negative findings were observed in those with baseline thoracic aortic calcification of 10 or greater. Results were similar for other pollutants and daytime noise. Conclusion Our study shows no overall associations. Subgroup analyses suggest independent associations of traffic-related air pollution and noise with the development and progression of subclinical atherosclerosis in participants with no or minor thoracic aortic calcification at baseline, in contrast to negative findings in those with advanced calcification.

Air Pollution and Progression of Atherosclerosis in Different Vessel Beds—Results from a Prospective Cohort Study in the Ruhr Area, Germany

“…In addition, observed results were robust with regard to adjustment for road traffic noise, a coexposure that has been shown to affect blood pressure (Kempen et al 2018;Münzel et al 2018), a major risk factor for the development of atherosclerosis. This finding was observed for all markers and in line with earlier studies that investigated thoracic calcification only (Hennig et al 2019;Kälsch et al 2013a). However, residual confounding of air pollution and noise cannot be ruled out due to possible noise exposure misclassification when using façade values and lack of personal exposure measures.…”

“…Two analyses of the Framingham Heart Study investigating progression of coronary and aortic calcification do not find any association with roadway proximity or ( Dorans et al. 2016 , 2017 ), whereas we had already observed associations restricted to participants with no or only minor manifestation of TAC at baseline in our prior study ( Hennig et al. 2019 ).…”

“…In contrast, the investigators observed positive association of PM 2:5 and NO 2 with CAC progression (Kaufman et al 2016), but others did not (Dorans et al 2016). TAC progression has been shown to be related to air pollution only in early stages of thoracic calcification, but not in more advanced stages of atherosclerosis (Hennig et al 2019).…”

“…Although short-term exposure to particulate matter (PM) can trigger acute cardiovascular events, long-term exposure to PM was linked to the development of underlying chronic cardiovascular pathologies (Franklin et al 2015), of which atherosclerosis is considered the major one (Künzli et al 2011). Although experimental animal studies provide strong evidence for air pollution causing atherosclerosis through oxidative stress and systemic inflammation (Araujo et al 2008;Soares et al 2009;Sun et al 2005), epidemiological evidence on air pollution effects on the development and progression of atherosclerosis along the pathway to cardiovascular endpoints is less consistent (Adar et al 2013;Gan et al 2014;Hennig et al 2019;Kaufman et al 2016;Künzli et al 2010;Wilker et al 2013).…”

“…2016 ). TAC progression has been shown to be related to air pollution only in early stages of thoracic calcification, but not in more advanced stages of atherosclerosis ( Hennig et al. 2019 ).…”