Air pollution, lifestyle, and… | 2025

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48/100

✓ Peer-reviewed alzhub usefulness score 48 out of 100. Prevention and risk

Topic: Risk, prevention and care in population studies

Plain-language summary

• Limited evidence links air pollution-lifestyle interplay to cardiovascular disease. • Study includes over 5.8 million participants from arid Northwestern China. • Air pollution in dust-prone areas is linked to cardiovascular disease. • Exercise is crucial in reducing the risk of cardiovascular disease from air pollution. • Air pollution and unhealthy lifestyles jointly heighten cardiovascular risk. Evidence on the combined impact of air pollution and lifestyle on cardiovascular disease (CVD) risk is limited. We employed the Space-Time Extra-Trees model, an ensemble learning method for spatiotemporal data, to estimate the annual average concentrations of five air pollutants from 2017 to 2019. Cox proportional hazards models were used to assess the associations between air pollutant exposure and CVD incidence. A lifestyle score, based on body mass index, waist circumference, diet, physical activity, alcohol consumption, and smoking, was developed to examine the moderating effect of lifestyle on the air pollution-CVD relationship. Among 5,838,833 baseline participants without CVD, 414,218 developed CVD during follow-up. Long-term exposure to particulate matter (PM 1 , PM 2.5 , PM 10 ), ozone (O 3 ), and carbon monoxide (CO) was significantly associated with increased CVD risk. Stratified analyses revealed that exercise had the most significant impact on this association, with exercisers showing a notable reduction in risk compared to non-exercisers. An interaction between air pollution and lifestyle was observed (P-interaction < 0.001). Compared to individuals with a relatively healthy lifestyle and low air pollution exposure, those with an unhealthy lifestyle and high exposure had the highest risk of developing CVD (PM 1 : HR = 1.660, PM 2.5 : HR = 1.891, PM 10 : HR = 1.755, O 3 : HR = 1.970, CO: HR = 1.426). Further analysis revealed a synergistic additive interaction between lifestyle and air pollution, leading to relative excess risks of 0.151, 0.154, 0.137, 0.171, and 0.095 in groups with relatively unhealthy lifestyles and high exposure to PM 1 , PM 2.5 , PM 10 , O 3 , and CO, respectively. Thus, in addition to controlling major air pollutant emissions, promoting healthy lifestyle adoption is crucial.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Ji, W., Lin, L., Cheng, Y., Yuan, Y., Zhao, Y., Wang, K., et al. (2025). Air pollution, lifestyle, and cardiovascular disease risk in northwestern China: A cohort study of over 5.8 million participants. Environment International. https://doi.org/10.1016/j.envint.2025.109459

Vancouver

Ji W, Lin L, Cheng Y, Yuan Y, Zhao Y, Wang K, et al. Air pollution, lifestyle, and cardiovascular disease risk in northwestern China: A cohort study of over 5.8 million participants. Environment International. 2025. doi:10.1016/j.envint.2025.109459. PMID: 40253932.

BibTeX

@article{ji2025-40253932,
  author  = {Ji, Weidong and Lin, Li and Cheng, Yinlin and Yuan, Yujuan and Zhao, Yu and Wang, Kai and Chen, Baoyu and Wang, Yushan and others},
  title   = {{Air pollution, lifestyle, and cardiovascular disease risk in northwestern China: A cohort study of over 5.8 million participants}},
  journal = {Environment International},
  year    = {2025},
  doi     = {10.1016/j.envint.2025.109459},
  pmid    = {40253932},
  url     = {https://doi.org/10.1016/j.envint.2025.109459}
}

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How to read this study

Design: our record does not state a study design, so check the methods section of the original before weighing the result.
Size: the record gives no participant count. Look for one in the original before trusting a pattern.
Effect: the record reports “HR = 1.660; HR = 1.891; HR = 1.755”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded low. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Low means the abstract matched neither pattern. It is the default label, and it does not mean the work is poor; many sound lab and imaging papers land here. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Long-term exposure to particulate matter (PM 1 , PM 2.5 , PM 10 ), ozone (O 3 ), and carbon monoxide (CO) was significantly associated with increased CVD risk.
Stratified analyses revealed that exercise had the most significant impact on this association, with exercisers showing a notable reduction in risk compared to non-exercisers.
Compared to individuals with a relatively healthy lifestyle and low air pollution exposure, those with an unhealthy lifestyle and high exposure had the highest risk of developing CVD (PM 1 : HR = 1.660, PM 2.5 : HR = 1.891, PM 10 : HR = 1.755, O 3 : HR = 1.970, CO: HR = 1.426).
Further analysis revealed a synergistic additive interaction between lifestyle and air pollution, leading to relative excess risks of 0.151, 0.154, 0.137, 0.171, and 0.095 in groups with relatively unhealthy lifestyles and high exposure to PM 1 , PM 2.5 , PM 10 , O 3 , and CO, respectively.

Why it matters

This cohort study is about cardiovascular disease, not Alzheimer's disease, and reports no findings on dementia treatment, cure, or prevention. It found that long-term exposure to several air pollutants was linked to higher cardiovascular risk, and that exercise and healthier lifestyles were linked to lower risk.

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Study details

Effect sizeHR = 1.660; HR = 1.891; HR = 1.755
Evidence strengthLow

How this study scored 48/100

Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Environment International)
Journal's citation record	3 / 4	Environment International: journal h-index 335 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	3 / 7	Cited 24 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	8.0 citations a year over 3 year(s) since 2025
Impact for its field and year	4 / 6	Cited 9.7× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	2 / 4	Cited 24 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	1 / 4	Last-listed author Yi xin Zhou: h-index 9 (OpenAlex, whole career)
Institution's track record	1 / 3	Tsinghua University: institution h-index 1,218 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 40253932)
Free to read	2 / 2	Free to read
Total	48 / 100	—

What each of these 20 components measures, and what this score is not →

Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

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