Abstract
Long-term trends in PM2.5-attributable cardiovascular diseases (CVDs) and subtypes mortality remain unclear between China and India, facing dual challenges of aging and severe air pollution. We aim to compare long-term trends and age-, period-, and cohort-effects changes in PM2.5-attributable CVD and subtypes mortality in China and India from 1990 to 2019. Data are derived from Global burden of disease 2019. Long-term trends and age-, period-, and cohort-effects changes were evaluated by join-point regression and age-period-cohort models. We found that in China, the age-standardized mortality rate in CVD potentially increased in 1990–2012, followed by a significant downwards trend in 2013–2019, while the rate was obviously upward in India from 1990 to 2019. The impact of PM2.5 on CVD and subtypes mortality increased sharply with age in both countries. The period risk ratios (RRs) began to significantly decline in 2010–2014 in China, while India revealed a noticeable increase during the 30 years. The cohort RRs are still increasing among the younger generation in China, while the impact in India is not as pronounced. These findings suggest that the older adults are more susceptible to the effects of PM2.5. And compared with India, the PM2.5 hazards in China have begun to reduce because of the early implementation of strict air pollution control policies, suggesting that it is more necessary for India to conduct strict and efficient air pollution control policies to increase the health benefits.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data of Global Burden of Disease has already publicly available.
References
Anwar MN, Shabbir M, Tahir E, Iftikhar M, Saif H, Tahir A, Murtaza MA, Khokhar MF, Rehan M, Aghbashlo M, Tabatabaei M, Nizami AS (2021) Emerging challenges of air pollution and particulate matter in China, India, and Pakistan and mitigating solutions. J Hazard Mater 416:125851. https://doi.org/10.1016/j.jhazmat.2021.125851
Apte JS, Marshall JD, Cohen AJ, Brauer M (2015) Addressing global mortality from ambient PM2.5. Environ Sci Technol 49(13):8057–8066. https://doi.org/10.1021/acs.est.5b01236
Chen R, Yin P, Meng X, Liu C, Wang L, Xu X, Ross JA, Tse LA, Zhao Z, Kan H, Zhou M (2017) Fine particulate air pollution and daily mortality. A Nationwide Analysis in 272 Chinese Cities. Am J Respir Crit Care Med 196(1):73–81. https://doi.org/10.1164/rccm.201609-1862OC
Du X, Patel A, Anderson CS, Dong J, Ma C (2019) Epidemiology of cardiovascular disease in China and opportunities for improvement: JACC International. J Am Coll Cardiol 73(24):3135–3147. https://doi.org/10.1016/j.jacc.2019.04.036
Fang EF, Scheibye-Knudsen M, Jahn HJ, Li J, Ling L, Guo H, Zhu X, Preedy V, Lu H, Bohr VA, Chan WY, Liu Y, Ng TB (2015) A research agenda for aging in China in the 21st century. Ageing Res Rev 24(Pt B):197–205. https://doi.org/10.1016/j.arr.2015.08.003
GBD 2019 Diseases and Injuries Collaborators (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1204–1222. https://doi.org/10.1016/s0140-6736(20)30925-9
GBD 2019 Risk Factors Collaborators (2020) Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1223–1249. https://doi.org/10.1016/s0140-6736(20)30752-2
Health Effects Institute (2020) State of Global Air 2020. https://www.stateofglobalair.org/resources/report/state-global-air-report-2020. Accessed 18 Apr 2023
Hu S-S (2022) Report on cardiovascular health and diseases in China 2021: an updated summary. Biomed Environ Sci 35(7):573–603. https://doi.org/10.3967/bes2022.079
Hystad P, Larkin A, Rangarajan S, AlHabib KF, Avezum Á, Calik KBT, Chifamba J, Dans A, Diaz R, du Plessis JL, Gupta R, Iqbal R, Khatib R, Kelishadi R, Lanas F, Liu Z, Lopez-Jaramillo P, Nair S, Poirier P, Rahman O, Rosengren A, Swidan H, Tse LA, Wei L, Wielgosz A, Yeates K, Yusoff K, Zatoński T, Burnett R, Yusuf S, Brauer M (2020) Associations of outdoor fine particulate air pollution and cardiovascular disease in 157 436 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet Planet Health 4(6):e235–e245. https://doi.org/10.1016/s2542-5196(20)30103-0
India State-Level Disease Burden Initiative Air Pollution Collaborators (2021) Health and economic impact of air pollution in the states of India: the Global Burden of Disease Study 2019. Lancet Planet Health 5(1):e25–e38. https://doi.org/10.1016/s2542-5196(20)30298-9
India State-Level Disease Burden Initiative CVD Collaborators (2018) The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016. Lancet Glob Health 6(12):e1339–e1351. https://doi.org/10.1016/s2214-109x(18)30407-8
Jiang Q, Feng Q (2022) Editorial: aging and health in China. Front Public Health 10:998769. https://doi.org/10.3389/fpubh.2022.998769
Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19(3):335–351. https://doi.org/10.1002/(sici)1097-0258(20000215)19:3%3c335::aid-sim336%3e3.0.co;2-z
Li Y, Zhang J (2022) Disease burden and risk factors of ischemic heart disease in China during 1990–2019 based on the Global Burden of Disease 2019 report: a systematic analysis. Front Public Health 10:973317. https://doi.org/10.3389/fpubh.2022.973317
Li S, Liu Z, Joseph P, Hu B, Yin L, Tse LA, Rangarajan S, Wang C, Wang Y, Islam S, Liu W, Lu F, Li Y, Hou Y, Qiang D, Zhao Q, Li N, Lei R, Chen D, Han A, Liu G, Zhang P, Zhi Y, Liu C, Yang J, Resalaiti A, Ma H, Ma Y, Liu Y, Xing X, Xiang Q, Liu Z, Sheng Y, Tang J, Liu L, Yusuf S, Li W (2022) Modifiable risk factors associated with cardiovascular disease and mortality in China: a PURE substudy. Eur Heart J 43(30):2852–2863. https://doi.org/10.1093/eurheartj/ehac268
Li Y, Cao GY, Jing WZ, Liu J, Liu M (2023) Global trends and regional differences in incidence and mortality of cardiovascular disease, 1990–2019: findings from 2019 global burden of disease study. Eur J Prev Cardiol 30(3):276–286. https://doi.org/10.1093/eurjpc/zwac285
Liang F, Liu F, Huang K, Yang X, Li J, Xiao Q, Chen J, Liu X, Cao J, Shen C, Yu L, Lu F, Wu X, Wu X, Li Y, Hu D, Huang J, Liu Y, Lu X, Gu D (2020) Long-term exposure to fine particulate matter and cardiovascular disease in China. J Am Coll Cardiol 75(7):707–717. https://doi.org/10.1016/j.jacc.2019.12.031
Liu YH, Bo YC, You J, Liu SF, Liu MJ, Zhu YJ (2023) Spatiotemporal trends of cardiovascular disease burden attributable to ambient PM(2.5) from. Sci Total Environ 885:163869. https://doi.org/10.1016/j.scitotenv.2023.163869
Liu, Q, Huang J, Guo B, Guo X (2016) Efficiency of emission control measures on particulate matter-related health impacts and economic cost during the 2014 Asia-Pacific Economic Cooperation Meeting in Beijing. Int J Environ Res Public Health 14(1). https://doi.org/10.3390/ijerph14010019
Loganathan S, Iyengar V, Chowdappa SV, Varghese M (2017) Population trends and public awareness of healthy and pathological ageing in India: a brief overview. Asian J Psychiatr 29:49–53. https://doi.org/10.1016/j.ajp.2017.04.012
Ma Y, Yang D, Bai J, Zhao Y, Hu Q, Yu C (2022) Time trends in stroke and subtypes mortality attributable to household air pollution in Chinese and Indian adults: an age-period-cohort analysis using the Global Burden of Disease Study 2019. Front Aging Neurosci 14:740549. https://doi.org/10.3389/fnagi.2022.740549
Maji KJ, Li VO, Lam JC (2020) Effects of China’s current air pollution prevention and control action plan on air pollution patterns, health risks and mortalities in Beijing 2014–2018. Chemosphere 260:127572. https://doi.org/10.1016/j.chemosphere.2020.127572
Ministry of Ecology and Environment of the People's Republic of China. (2022) Report on the State of the Environment. https://www.mee.gov.cn/hjzl/sthjzk. Accessed 18 Apr 2023
Prabhakaran D, Jeemon P, Roy A (2016) Cardiovascular diseases in India: current epidemiology and future directions. Circulation 133(16):1605–1620. https://doi.org/10.1161/circulationaha.114.008729
Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, Bonny A, Brauer M, Brodmann M, Cahill TJ, Carapetis J, Catapano AL, Chugh SS, Cooper LT, Coresh J, Criqui M, DeCleene N, Eagle KA, Emmons-Bell S, Feigin VL, Fernández-Solà J, Fowkes G, Gakidou E, Grundy SM, He FJ, Howard G, Hu F, Inker L, Karthikeyan G, Kassebaum N, Koroshetz W, Lavie C, Lloyd-Jones D, Lu HS, Mirijello A, Temesgen AM, Mokdad A, Moran AE, Muntner P, Narula J, Neal B, Ntsekhe M, Moraes de Oliveira G, Otto C, Owolabi M, Pratt M, Rajagopalan S, Reitsma M, Ribeiro ALP, Rigotti N, Rodgers A, Sable C, Shakil S, Sliwa-Hahnle K, Stark B, Sundström J, Timpel P, Tleyjeh IM, Valgimigli M, Vos T, Whelton PK, Yacoub M, Zuhlke L, Murray C, Fuster V (2020) Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol 76(25):2982–3021. https://doi.org/10.1016/j.jacc.2020.11.010
Sang S, Chu C, Zhang T, Chen H, Yang X (2022) The global burden of disease attributable to ambient fine particulate matter in 204 countries and territories, 1990–2019: a systematic analysis of the Global Burden of Disease Study 2019. Ecotoxicol Environ Saf 238:113588. https://doi.org/10.1016/j.ecoenv.2022.113588
Sun Y, Mu J, Wang DW, Ouyang N, Xing L, Guo X, Zhao C, Ren G, Ye N, Zhou Y, Wang J, Li Z, Sun G, Yang R, Chen CS, He J (2022) A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial. Lancet 399(10339):1964–1975. https://doi.org/10.1016/s0140-6736(22)00325-7
Tu, P, Tian Y, Hong Y, Yang L, Huang J, Zhang H, Mei X, Zhuang Y, Zou X, He C (2022) Exposure and inequality of PM(2.5) pollution to Chinese population: a case study of 31 provincial capital cities from 2000 to 2016. Int J Environ Res Public Health 19(19). https://doi.org/10.3390/ijerph191912137
Wang Y, Peng X, Nie X, Chen L, Weldon R, Zhang W, Xiao D, Cai J (2016) Burden of hypertension in China over the past decades: systematic analysis of prevalence, treatment and control of hypertension. Eur J Prev Cardiol 23(8):792–800. https://doi.org/10.1177/2047487315617105
Wang W, Zhao C, Dong C, Yu H, Wang Y, Yang X (2022) Is the key-treatment-in-key-areas approach in air pollution control policy effective? Evidence from the action plan for air pollution prevention and control in China. Sci Total Environ 843:156850. https://doi.org/10.1016/j.scitotenv.2022.156850
Wang H, Zhang H, Zou Z (2023) Changing profiles of cardiovascular disease and risk factors in China: a secondary analysis for the Global Burden of Disease Study 2019. Chin Med J (engl). https://doi.org/10.1097/cm9.0000000000002741
WHO (2022) WHO Air quality Database 2022. https://www.who.int/publications/m/item/who-air-quality-database-2022. Accessed 18 Apr 2023
Yue H, He C, Huang Q, Yin D, Bryan BA (2020) Stronger policy required to substantially reduce deaths from PM(2.5) pollution in China. Nat Commun 11(1):1462. https://doi.org/10.1038/s41467-020-15319-4
Zhang L, Fu S, Wang Y, Fang Y (2022) Research on the optimization of financing scheme of long-term care insurance in China based on system dynamics simulation. Front Public Health 10:908864. https://doi.org/10.3389/fpubh.2022.908864
Zhang J, Tong H, Jiang L, Zhang Y, Hu J (2023) Trends and disparities in China’s cardiovascular disease burden from 1990 to 2019. Nutr Metab Cardiovasc Dis. https://doi.org/10.1016/j.numecd.2023.07.039
Zhao D, Liu J, Wang M, Zhang X, Zhou M (2019) Epidemiology of cardiovascular disease in China: current features and implications. Nat Rev Cardiol 16(4):203–212. https://doi.org/10.1038/s41569-018-0119-4
Zhao, Y, Kim B (2022) Environmental regulation and chronic conditions: evidence from China’s air pollution prevention and control action plan. Int J Environ Res Public Health 19(19). https://doi.org/10.3390/ijerph191912584
Funding
This work was supported by the Fundamental Research Funds for Higher Education of Tianjin Municipal Education Commission [grant number: 2021ZD038].
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Honglu Zhang, Xueli Yang, and Nai-jun Tang. The first draft of the manuscript was written by Honglu Zhang. And Ze Yang, Hongyue Sun, Pranita Tiwari, and Jing Wu revised the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval
Not applicable.
Consent to participate
Not applicable.
Competing interests
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zhang, H., Yang, Z., Sun, H. et al. Changing patterns for cardiovascular disease and subtypes mortality attributable to ambient fine particulate matter pollution between China and India during 1990 to 2019. Air Qual Atmos Health 17, 921–930 (2024). https://doi.org/10.1007/s11869-023-01487-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11869-023-01487-x