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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.

Sec. Cardiovascular Epidemiology and Prevention

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1653870

This article is part of the Research TopicThe Role of Environmental and Metabolic Factors in Global Cardiovascular HealthView all 8 articles

Global Trends in Ambient Particulate Matter–Attributable Ischemic Heart Disease Among the Elderly (1990–2021)

Provisionally accepted
Yangxi  ZengYangxi ZengLiu  LihuiLiu LihuiGang  HuangGang HuangCan  LiuCan LiuXi  LanXi LanYuhan  MouYuhan MouXinyu  WangXinyu WangBin  LiaoBin Liao*Juyi  WanJuyi Wan*
  • The Affiliated Hospital of Southwest Medical University, Luzhou, China

The final, formatted version of the article will be published soon.

Background: Airborne particulate matter (PM), particularly PM₂.₅, poses a growing threat to cardiovascular health, especially among older adults. With intensified urbanization and industrial activities, PM₂.₅ has become a major factor contributing to ischemic heart disease (IHD), a leading cause of global mortality. These fine particles can penetrate pulmonary defenses, enter circulation, and trigger inflammatory and oxidative pathways that accelerate vascular damage. The elderly, whose physiological resilience declines with age, are particularly susceptible. While PM exposure’s link to IHD is established, patterns by sex and age in older populations remain underexplored. This study assesses global, regional, and national shifts in PM-related IHD burden between 1990 and 2021, identifies disparities across demographics, and examines the influence of socioeconomic development. It also forecasts trends to 2040, providing insights to guide public health interventions for aging societies.Methods: Using the Global Burden of Disease study (GBD 2021), we analyzed mortality and disability adjusted life years (DALYs) from 1990 to 2021 across global, regional, and national levels. We calculated age standardized rates (ASRs) and estimated annual percentage changes (EAPCs). Future trends were projected using a Bayesian age–period–cohort (BAPC) model. Modelling was performed in R, disaggregated by sex and age, linked with PM exposure and socioeconomic development.Results: Overall IHD due to PM declined globally from 1990 to 2021. The largest reductions occurred in high-SDI regions. Burden increased in low- and middle-income areas in Asia and Africa. Globally, IHD burden from PM was negatively correlated with sociodemographic index (SDI). Men had higher burdens than women, with differences increasing by age. Although BAPC projections indicate a continued decline, a potential rise in pollution around 2035 may slow the rate of decrease or temporarily flatten the downward trajectory.Conclusion: Although global declines have been observed, the burden of ischemic heart disease (IHD) attributable to ambient particulate matter pollution remains persistently high in Southeast Asia and Africa. Forecasts suggest that elderly individuals, particularly men, will continue to experience disproportionate health impacts in the coming decades. Targeted public health initiatives focused on reducing particulate matter exposure, especially among vulnerable aging populations, are essential to mitigate future cardiovascular risks and promote healthy aging worldwide.

Keywords: Ambient particulate matter (PM), Ischemic heart disease (IHD), Global Burden of Disease (GBD 2021), elderly population, estimated annual percentage change (EAPC)

Received: 25 Jun 2025; Accepted: 07 Oct 2025.

Copyright: © 2025 Zeng, Lihui, Huang, Liu, Lan, Mou, Wang, Liao and Wan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Bin Liao, liaobin@swmu.edu.cn
Juyi Wan, wanjuyi@swmu.edu.cn

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