Long-Term Exposure to Ambient Fine Particles and Heart Rate in Northwestern China: Findings from 1.8 Million Adults of the Kashgar Prospective Cohort Study (KPCS)

Elevated heart rate (HR) can be hypothesized to be involved in the pathways by which ambient air pollution, especially fine particulate matter (PM2.5), causes cardiovascular morbidity and mortality. However, evidence concerning long-term PM2.5 exposure and HR is still limited. Therefore, in this study, we assessed the associations of PM2.5 with HR levels and tachycardia prevalence and explored potential modifiers of the associations. We used baseline data of 1,802,207 adults from the Kashgar Prospective Cohort Study (KPCS). PM2.5 exposure was assessed based on satellite sensing data, meteorological factors, multi-resolution emission inventory, and measurements from ground-based surface monitors measurements. HR was measured using a calibrated electronic sphygmomanometer, and tachycardia was defined as resting heart rate (RHR) equal to or greater than 80 beats per minute. Linear regression and logistic regression models were employed to evaluate the associations of PM2.5 levels with RHR levels and tachycardia prevalence, respectively. Stratified analyses by sex, age, ethnicity, smoking status, alcohol use, and physical activity were also performed. The mean (standard deviation) age of the study participants was 39.4 (15.5) years old. In the adjusted models, an interquartile range (8.8 µg/m3) increase in PM2.5 levels was associated with 0.515 (95% confidence interval: 0.503–0.526) bpm increase in RHR levels and with 1.062-fold (95% confidence interval: 1.059–1.064) increase in the odds of tachycardia. The results were robust against several sensitivity analyses. In addition, we observed the above associations were stronger in participants that were men, of Uyghur ethnicity, smoking cigarettes, drinking alcohol, and having physical inactivity, compared to their counterparts. In summary, our findings indicate that long-term exposure to ambient PM2.5 may be hazardously associated with HR, and women, Uyghur people, and those with unhealthy lifestyles may be more vulnerable to the hazardous effects.