Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia

Background Sedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear. Methods and Results We analyzed data...

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Main Authors: Hye Jun Kim, Yun Hwan Oh, Sun Jae Park, Jihun Song, Kyuwoong Kim, Daein Choi, Seogsong Jeong, Sang Min Park
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.035933
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author Hye Jun Kim
Yun Hwan Oh
Sun Jae Park
Jihun Song
Kyuwoong Kim
Daein Choi
Seogsong Jeong
Sang Min Park
author_facet Hye Jun Kim
Yun Hwan Oh
Sun Jae Park
Jihun Song
Kyuwoong Kim
Daein Choi
Seogsong Jeong
Sang Min Park
author_sort Hye Jun Kim
collection DOAJ
description Background Sedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear. Methods and Results We analyzed data from 113 918 newly diagnosed patients with dyslipidemia (2009–2012) without prior CVD, sourced from the Korea National Health Insurance Service. Ambient particulate matter (PM) 2.5 and PM10 levels were collected from the National Ambient Air Monitoring System in South Korea. Changes in PA, measured in metabolic equivalents of task–min/wk before and after dyslipidemia diagnosis, were evaluated for associations with air pollution levels and CVD risk using Cox proportional hazards regression. Patients were followed from January 1, 2013, until CVD onset, death, or December 31, 2021. Among patients exposed to low to moderate PM2.5 levels (≤25 μg/m3), increasing PA from inactive to ≥1000 metabolic equivalents of tasks–min/wk was associated with a lower risk of CVD (adjusted hazard ratio, 0.82 [95% CI, 0.70–0.97]; P for trend=0.022). In high PM2.5 (>25 μg/m3) conditions, increasing PA from inactive and decreasing PA from ≥1000 metabolic equivalents of task–min/wk was associated with reduced (P for trend=0.010) and elevated (P for trend=0.028) CVD risks, respectively. For PM10, increased PA was linked to reduced CVD risk (P for trend=0.002) and decreased PA to elevated risk (P for trend=0.042) in low to moderate PM10 (≤50 μg/m3) conditions, though benefits diminished at high PM10 (>50 μg/m3) exposures. Conclusions Promoting PA, while considering the high potential cardiovascular risk associated with air pollution, may be an effective intervention against CVD in patients with dyslipidemia.
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spelling doaj-art-ccc3f0dcf91b4a30a22a82671d0f73152024-12-03T10:06:25ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-12-01132310.1161/JAHA.124.035933Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With DyslipidemiaHye Jun Kim0Yun Hwan Oh1Sun Jae Park2Jihun Song3Kyuwoong Kim4Daein Choi5Seogsong Jeong6Sang Min Park7Department of Biomedical Sciences Seoul National University College of Medicine Seoul South KoreaDepartment of Family Medicine Chung–Ang University Gwangmyeong Hospital, Chung–Ang University College of Medicine Gwangmyeong South KoreaDepartment of Biomedical Sciences Seoul National University College of Medicine Seoul South KoreaDepartment of Biomedical Sciences Seoul National University College of Medicine Seoul South KoreaNational Cancer Control Institute, National Cancer Center Goyang South KoreaDepartment of Medicine Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel New York City NYDepartment of Biomedical Informatics Korea University College of Medicine Seoul South KoreaDepartment of Biomedical Sciences Seoul National University College of Medicine Seoul South KoreaBackground Sedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear. Methods and Results We analyzed data from 113 918 newly diagnosed patients with dyslipidemia (2009–2012) without prior CVD, sourced from the Korea National Health Insurance Service. Ambient particulate matter (PM) 2.5 and PM10 levels were collected from the National Ambient Air Monitoring System in South Korea. Changes in PA, measured in metabolic equivalents of task–min/wk before and after dyslipidemia diagnosis, were evaluated for associations with air pollution levels and CVD risk using Cox proportional hazards regression. Patients were followed from January 1, 2013, until CVD onset, death, or December 31, 2021. Among patients exposed to low to moderate PM2.5 levels (≤25 μg/m3), increasing PA from inactive to ≥1000 metabolic equivalents of tasks–min/wk was associated with a lower risk of CVD (adjusted hazard ratio, 0.82 [95% CI, 0.70–0.97]; P for trend=0.022). In high PM2.5 (>25 μg/m3) conditions, increasing PA from inactive and decreasing PA from ≥1000 metabolic equivalents of task–min/wk was associated with reduced (P for trend=0.010) and elevated (P for trend=0.028) CVD risks, respectively. For PM10, increased PA was linked to reduced CVD risk (P for trend=0.002) and decreased PA to elevated risk (P for trend=0.042) in low to moderate PM10 (≤50 μg/m3) conditions, though benefits diminished at high PM10 (>50 μg/m3) exposures. Conclusions Promoting PA, while considering the high potential cardiovascular risk associated with air pollution, may be an effective intervention against CVD in patients with dyslipidemia.https://www.ahajournals.org/doi/10.1161/JAHA.124.035933cardiovascular diseasecohort studydyslipidemialifestyle behaviorparticulate matterphysical activity
spellingShingle Hye Jun Kim
Yun Hwan Oh
Sun Jae Park
Jihun Song
Kyuwoong Kim
Daein Choi
Seogsong Jeong
Sang Min Park
Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular disease
cohort study
dyslipidemia
lifestyle behavior
particulate matter
physical activity
title Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
title_full Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
title_fullStr Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
title_full_unstemmed Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
title_short Combined Effects of Air Pollution and Changes in Physical Activity With Cardiovascular Disease in Patients With Dyslipidemia
title_sort combined effects of air pollution and changes in physical activity with cardiovascular disease in patients with dyslipidemia
topic cardiovascular disease
cohort study
dyslipidemia
lifestyle behavior
particulate matter
physical activity
url https://www.ahajournals.org/doi/10.1161/JAHA.124.035933
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