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Background <p>Cardiovascular diseases are common in aging populations and are closely associated with multiple factors. However, the cumulative effects of green-space exposure and air pollutants on cardiovascular disease have not been adequately investigated.</p> Methods <p>This study used CHARLS 2015 data and CLHLS 2014 data. Green-space exposure was quantified using the normalized difference vegetation index (NDVI), while exposures to PM2.5, NO<sub>2</sub> and SO<sub>2</sub> were assessed using the China High-resolution Air Pollutant dataset (CHAP). A composite cardiometabolic risk score was derived from five metabolic syndrome (MetS) diagnostic components: abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein. Generalized linear models (GLMs) were applied to evaluate the effects of green-space exposure and air pollutants on cardiovascular disease risk; single-, two-, and three-pollutant models were fitted, and interaction and sensitivity analyses were conducted to assess the robustness of the findings.</p> Results <p>Green-space exposure was associated with a lower risk of cardiovascular disease (OR = 0.867, 95% CI: 0.796–0.944, <i>P</i> = 0.001), while exposures to PM2.5, NO<sub>2</sub>, and SO<sub>2</sub> were all linked to an increased risk. Among these pollutants, NO<sub>2</sub> showed the strongest association, with each interquartile range (IQR) increase corresponding to a 25.9% higher risk of cardiovascular disease (OR = 1.259, 95% CI: 1.152–1.377, <i>P</i> &lt; 0.001). Interaction analysis revealed that higher green-space exposure had a more pronounced protective effect under low levels of air pollution. However, under high pollution levels, greater green-space exposure appeared to amplify the adverse effects of pollutants on cardiovascular disease risk. In the multi-pollutant model, after further adjusting for three pollutants, the association between PM2.5 (OR = 1.179, 95% CI: 1.017–1.366, <i>P</i> = 0.028) and NO<sub>2</sub> (OR = 1.165, 95% CI: 1.012–1.341, <i>P</i> = 0.034) and cardiovascular disease risk remained significant.</p> Conclusions <p>Evidence indicates that green-space exposure confers protection for cardiovascular health, but this effect is significantly modulated by ambient air pollution.</p>

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Interactive effects of green-space exposure and air pollution on cardiovascular disease risk: a study based on the CHARLS and CLHLS databases

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月23日

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  • Xiaolong Chuai,
  • Yazhe Dai,
  • Haotian Cai,
  • Yuxian Li,
  • Shengxue Zhou,
  • Lihong Zhao,
  • Min Yang

摘要

Background

Cardiovascular diseases are common in aging populations and are closely associated with multiple factors. However, the cumulative effects of green-space exposure and air pollutants on cardiovascular disease have not been adequately investigated.

Methods

This study used CHARLS 2015 data and CLHLS 2014 data. Green-space exposure was quantified using the normalized difference vegetation index (NDVI), while exposures to PM2.5, NO2 and SO2 were assessed using the China High-resolution Air Pollutant dataset (CHAP). A composite cardiometabolic risk score was derived from five metabolic syndrome (MetS) diagnostic components: abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein. Generalized linear models (GLMs) were applied to evaluate the effects of green-space exposure and air pollutants on cardiovascular disease risk; single-, two-, and three-pollutant models were fitted, and interaction and sensitivity analyses were conducted to assess the robustness of the findings.

Results

Green-space exposure was associated with a lower risk of cardiovascular disease (OR = 0.867, 95% CI: 0.796–0.944, P = 0.001), while exposures to PM2.5, NO2, and SO2 were all linked to an increased risk. Among these pollutants, NO2 showed the strongest association, with each interquartile range (IQR) increase corresponding to a 25.9% higher risk of cardiovascular disease (OR = 1.259, 95% CI: 1.152–1.377, P < 0.001). Interaction analysis revealed that higher green-space exposure had a more pronounced protective effect under low levels of air pollution. However, under high pollution levels, greater green-space exposure appeared to amplify the adverse effects of pollutants on cardiovascular disease risk. In the multi-pollutant model, after further adjusting for three pollutants, the association between PM2.5 (OR = 1.179, 95% CI: 1.017–1.366, P = 0.028) and NO2 (OR = 1.165, 95% CI: 1.012–1.341, P = 0.034) and cardiovascular disease risk remained significant.

Conclusions

Evidence indicates that green-space exposure confers protection for cardiovascular health, but this effect is significantly modulated by ambient air pollution.