Healthier lifestyles can modify the air pollutants effect on cardiovascular disease among the middle-aged and elderly
Chen, Y. et al. Early adulthood BMI and cardiovascular disease: a prospective cohort study from the China kadoorie biobank. Lancet Public. Health. 9 (12), e1005–e1013 (2024).
Google Scholar
Diao, T. et al. Changes in sleep patterns, genetic susceptibility, and incident cardiovascular disease in China. JAMA Netw. Open. 7 (4), e247974 (2024).
Google Scholar
Du, X., Patel, A., Anderson, C. S., Dong, J. & Ma, C. Epidemiology of cardiovascular disease in China and opportunities for improvement: JACC international. J. Am. Coll. Cardiol. 73 (24), 3135–3147 (2019).
Google Scholar
Li, F. et al. Association between the cumulative average triglyceride glucose-body mass index and cardiovascular disease incidence among the middle-aged and older population: a prospective nationwide cohort study in China. Cardiovasc. Diabetol. 23 (1), 16 (2024).
Google Scholar
Wang, L. et al. A prospective study of waist circumference trajectories and incident cardiovascular disease in China: the Kailuan cohort study. Am. J. Clin. Nutr. 113 (2), 338–347 (2021).
Google Scholar
Liang, F. et al. Long-Term exposure to fine particulate matter and cardiovascular disease in China. J. Am. Coll. Cardiol. 75 (7), 707–717 (2020).
Google Scholar
Mehta, L. S. Cardiovascular Disease Risk Factors in Women: The Impact of Race and Ethnicity: A Scientific Statement From the American Heart Association. 147(19):1471–1487. (2023).
Teo, K. K. & Rafiq, T. Cardiovascular risk factors and prevention: A perspective from developing countries. Can. J. Cardiol. 37 (5), 733–743 (2021).
Google Scholar
Lan, J. et al. Effects of ambient air pollution on outpatient visits for psoriasis in Wuhan, China: a time-series analysis. Br. J. Dermatol. 188 (4), 491–498 (2023).
Google Scholar
Bhatnagar, A. Cardiovascular effects of particulate air pollution. Annu. Rev. Med. 73, 393–406 (2022).
Google Scholar
Shan, Y., Wang, X. & Wang, Z. The pattern and mechanism of air pollution in developed coastal areas of China: from the perspective of urban agglomeration. 15(9):e0237863. (2020).
Sing, T. F., Wang, W. & Zhan, C. Tracking industry pollution sources and health risks in China. Sci. Rep. 13 (1), 22232 (2023).
Google Scholar
Lederer, A. M., Fredriksen, P. M., Nkeh-Chungag, B. N. & Everson, F. Cardiovascular effects of air pollution: current evidence from animal and human studies. 320(4):H1417–h1439. (2021).
Fitriyah, A. et al. Exposure to ambient air pollution and osteoarthritis; an animal study. Chemosphere 301, 134698 (2022).
Google Scholar
Wang, J. et al. Direct and indirect consumption activities drive distinct urban-rural inequalities in air pollution-related mortality in China. Environ. Health Perspect. 69 (4), 544–553 (2024).
Google Scholar
Yang, Z. et al. Understanding China’s industrialization driven water pollution stress in 2002-2015-A multi-pollutant based net Gray water footprint analysis. J. Environ. Manage. 310, 114735 (2022).
Google Scholar
Yu, L. J. et al. Short-Term exposure to ambient air pollution and influenza: A multicity study in China. 131(12):127010. (2023).
Kaminsky, L. A. et al. The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Prog. Cardiovasc. Dis. 70, 8–15 (2022).
Google Scholar
Huang, Y. et al. Healthy lifestyle habits, educational attainment, and the risk of 45 age-related health and mortality outcomes in the UK: A prospective cohort study. J. Nutr. Health Aging. 29 (5), 100525 (2025).
Google Scholar
Shan, Y., Bertrand, K. A., Petrick, J. L., Sheehy, S. & Palmer, J. R. Planetary health diet index in relation to mortality in a prospective cohort study of united States black females. Am. J. Clin. Nutr. 121 (3), 589–596 (2025).
Google Scholar
Tian, F. et al. Post-cardiovascular disease healthy lifestyle, inflammation and metabolic biomarkers, and risk of dementia: a population-based longitudinal study. Am. J. Clin. Nutr. 121 (3), 511–521 (2025).
Google Scholar
Zhang, Y. B. et al. Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. J. Epidemiol. Commun. Health. 75 (1), 92–99 (2021).
Google Scholar
Peralta, A. A. et al. Low-level PM 2.5 exposure, cardiovascular and nonaccidental mortality, and related health disparities in 12 US States. Epidemiol. (Cambridge Mass). 36 (2), 253–263 (2025).
Google Scholar
Wu, D. et al. Effect of PM(2.5) and its constituents on hospital admissions for cardiometabolic Multimorbidity in Urumqi, China. Sci. Rep. 15 (1), 6394 (2025).
Google Scholar
Zou, Z. et al. Heat wave, fine particulate matter, and cardiovascular disease mortality: A time-stratified case-crossover study in Shenzhen, China. Ecotoxicol. Environ. Saf. 292, 117944 (2025).
Google Scholar
Zhang, S., Qian, Z. M. & Chen, L. Exposure to air pollution during Pre-Hypertension and subsequent hypertension, cardiovascular disease, and death: A trajectory analysis of the UK biobank cohort. 131(1):17008. (2023).
Guo, C. et al. Associations of healthy lifestyle and three latent socioeconomic status patterns with physical Multimorbidity among middle-aged and older adults in China. Prev. Med. 175, 107693 (2023).
Google Scholar
Yao, Y., Wang, K. & Xiang, H. Association between cognitive function and ambient particulate matters in middle-aged and elderly Chinese adults: evidence from the China health and retirement longitudinal study (CHARLS). Sci. Total Environ. 828, 154297 (2022).
Google Scholar
Han, S. et al. Systemic inflammation accelerates the adverse effects of air pollution on metabolic syndrome: findings from the China health and retirement longitudinal study (CHARLS). Environ. Res. 215 (Pt 1), 114340 (2022).
Google Scholar
Patterson, F., Grandner, M. A., Lozano, A., Satti, A. & Ma, G. Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample. Addict. Behav. 77, 47–50 (2018).
Google Scholar
Patterson, F. et al. Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors. Eur. J. Pub. Health. 28 (1), 155–161 (2018).
Google Scholar
Nelson, K. L. & Davis, J. E. Sleep quality: an evolutionary concept analysis. 57(1):144–151. (2022).
Dugmore, J. A., Winten, C. G., Niven, H. E. & Bauer, J. Effects of weight-neutral approaches compared with traditional weight-loss approaches on behavioral, physical, and psychological health outcomes: a systematic review and meta-analysis. Nutr. Rev. 78 (1), 39–55 (2020).
Google Scholar
Zhao, Q., Feng, Q. & Seow, W. J. Impact of air pollution on depressive symptoms and the modifying role of physical activity: evidence from the CHARLS study. J. Hazard. Mater. 482, 136507 (2024).
Google Scholar
Chen, N., Ma, L. L., Zhang, Y. & Yan, Y. X. Association of household solid fuel use and long-term exposure to ambient air pollution with estimated 10-year high cardiovascular disease risk among postmenopausal women. Environmental pollution (Barking, Essex: 2024, 342:123091. (1987).
Jiang, H. et al. Does physical activity attenuate the association between ambient PM(2.5) and physical function? Sci. Total Environ. 874, 162501 (2023).
Google Scholar
Yu, Y. et al. Association of residential greenness, air pollution with adverse birth outcomes: results from 61,762 mother–neonatal pairs in project ELEFANT (2011–2021). Sci. Total Environ. 912, 169549 (2024).
Google Scholar
Niu, L., Ye, H., Xu, C., Yao, Y. & Liu, W. Highly time- and size-resolved fingerprint analysis and risk assessment of airborne elements in a megacity in the Yangtze river delta, China. Chemosphere 119, 112–121 (2015).
Google Scholar
Environmental health: a global access science source.
Gao, N. et al. Lung function and systemic inflammation associated with short-term air pollution exposure in chronic obstructive pulmonary disease patients in Beijing. China 19 (1), 12 (2020).
Google Scholar
Wu, X., Chen, B., Wen, T., Habib, A. & Shi, G. Concentrations and chemical compositions of PM(10) during hazy and non-hazy days in Beijing. J. Environ. Sci. 87, 1–9 (2020).
Google Scholar
Yang, S. et al. Haze formation indicator based on observation of critical carbonaceous species in the atmosphere. Environmental pollution (Barking, Essex: 2019, 244:84–92. (1987).
Xu, T. et al. Association between solid cooking fuel and cognitive decline: three nationwide cohort studies in middle-aged and older population. Environ. Int. 173, 107803 (2023).
Google Scholar
Yang, B. Y. et al. Association of Long-term exposure to ambient air pollutants with risk factors for cardiovascular disease in China. JAMA Netw. Open. 2 (3), e190318 (2019).
Google Scholar
Jiang, Y., Du, C. & Chen, R. Differential effects of fine particulate matter constituents on acute coronary syndrome onset. 15(1):10848. (2024).
Sun, H. & Chen, X. Association between Long-Term exposure to PM(2.5) inorganic chemical compositions and cardiopulmonary mortality: A 22-Year cohort study in Northern China. 2(8):530–540. (2024).
Hayes, R. B. et al. PM2.5 air pollution and cause-specific cardiovascular disease mortality. Int. J. Epidemiol. 49 (1), 25–35 (2020).
Google Scholar
Krittanawong, C. et al. PM2.5 and cardiovascular health risks. Curr. Probl. Cardiol. 48 (6), 101670 (2023).
Google Scholar
Wang, M. et al. Ambient air pollution, healthy diet and vegetable intakes, and mortality: a prospective UK biobank study. 51(4):1243–1253. (2022).
de Bont, J. et al. Ambient air pollution and cardiovascular diseases: an umbrella review of systematic reviews and meta-analyses. 291(6):779–800. (2022).
Hayes, R. B. et al. PM2.5 air pollution and cause-specific cardiovascular disease mortality. Environ. Health Perspect. 49 (1), 25–35 (2020).
Ding, R., Huang, L., Yan, K., Sun, Z. & Duan, J. New insight into air pollution-related cardiovascular disease: an adverse outcome pathway framework of PM2.5-associated vascular calcification. Cardiovascular. Res. 120 (7), 699–707 (2024).
Google Scholar
Wang, X. et al. The role of sources and meteorology in driving PM(2.5)-bound Chlorine. J. Hazard. Mater. 441, 129910 (2023).
Google Scholar
Vieira de Oliveira Salerno, P. R. et al. The cardiovascular disease burden attributable to particulate matter pollution in South America: analysis of the 1990–2019 global burden of disease. Public. Health. 224, 169–177 (2023).
Google Scholar
Vienneau, D. et al. More than clean air and tranquillity: residential green is independently associated with decreasing mortality. Environ. Int. 108, 176–184 (2017).
Google Scholar
Bravo-Linares, C. et al. Source identification, apportionment and toxicity of indoor and outdoor PM2.5 airborne particulates in a region characterised by wood burning. Environ. Sci. Processes Impacts. 18 (5), 575–589 (2016).
Google Scholar
Cui, M. et al. Chemical composition of PM2.5 from two tunnels with different vehicular fleet characteristics. Sci. Total Environ. 550, 123–132 (2016).
Google Scholar
Osornio-Vargas, A. R. et al. In vitro biological effects of airborne PM₂.₅ and PM₁₀ from a semi-desert City on the Mexico-US border. Chemosphere 83 (4), 618–626 (2011).
Google Scholar
Valdés, A. et al. Elemental concentrations of ambient particles and cause specific mortality in Santiago, Chile: a time series study. Environ. Health: Global Access. Sci. Source. 11, 82 (2012).
Google Scholar
Wang, X. et al. [Pollution characteristics and source apportionment of PM₂.₅, in Lanzhou City]. Huan Jing Ke xue = Huanjing Kexue. 37 (5), 1619–1628 (2016).
Google Scholar
Yang, L. et al. Impacts of firecracker burning on aerosol chemical characteristics and human health risk levels during the Chinese new year celebration in Jinan, China. Sci. Total Environ. 476–477, 57–64 (2014).
Google Scholar
Cao, M. et al. Domestic wastewater causes nitrate pollution in an agricultural watershed, China. Sci. Total Environ. 823, 153680 (2022).
Google Scholar
Wang, H. et al. Formation mechanism and control strategy for particulate nitrate in China. J. Environ. Sci. 123, 476–486 (2023).
Google Scholar
Li, J. et al. Long-term effects of PM(2.5) components on blood pressure and hypertension in Chinese children and adolescents. Environ. Int. 161, 107134 (2022).
Google Scholar
Feng, J. et al. The effects of long-term exposure to air pollution on incident mental disorders among patients with prediabetes and diabetes: findings from a large prospective cohort. Sci. Total Environ. 897, 165235 (2023).
Google Scholar
Wu, Y. et al. Ambient air pollution associated with incidence and dynamic progression of type 2 diabetes: a trajectory analysis of a population-based cohort. 20(1):375. (2022).
Zou, H. et al. Ambient air pollution associated with incidence and progression trajectory of cardiometabolic diseases: A multi-state analysis of a prospective cohort. BMC Med. 862, 160803 (2023).
Google Scholar
Chen, W. et al. Household air pollution, adherence to a healthy lifestyle, and risk of cardiometabolic Multimorbidity: results from the China health and retirement longitudinal study. Sci. Total Environ. 855, 158896 (2023).
Google Scholar
Fukuie, M. et al. The effect of Head-Out aquatic exercise on arterial stiffness in Middle-Aged and elderly people. Pulse (Basel Switzerland). 7 (1–4), 51–59 (2020).
Google Scholar
Garnvik, L. E. et al. Physical activity, cardiorespiratory fitness, and cardiovascular outcomes in individuals with atrial fibrillation: the HUNT study. Eur. Heart J. 41 (15), 1467–1475 (2020).
Google Scholar
Lima, T. R., González-Chica, D. A., Moreno, Y. M. F. & Silva, D. A. S. Healthy lifestyle moderates the relationship between cardiovascular disease with blood pressure, body composition, carotid intima-media thickness, and glycated hemoglobin among adults. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 45(5):539–546. (2020).
Speer, K. E., Semple, S., Naumovski, N. & McKune, A. J. Heart rate variability for determining autonomic nervous system effects of lifestyle behaviors in early life: A systematic review. Physiol. Behav. 217, 112806 (2020).
Google Scholar
Vega, R. B., Konhilas, J. P., Kelly, D. P. & Leinwand, L. A. Molecular mechanisms underlying cardiac adaptation to exercise. Cell Metabol. 25 (5), 1012–1026 (2017).
Google Scholar
Kim, S. R., Choi, S., Keum, N. & Park, S. M. Combined effects of physical activity and air pollution on cardiovascular disease: A Population-Based study. J. Am. Heart Association. 9 (11), e013611 (2020).
Google Scholar
Juneja Gandhi, T., Garg, P. R. & Kurian, K. Outdoor physical activity in an air polluted environment and its effect on the cardiovascular System-A systematic review. 19(17). (2022).
Chatburn, A., Lushington, K. & Kohler, M. J. Complex associative memory processing and sleep: a systematic review and meta-analysis of behavioural evidence and underlying EEG mechanisms. Neurosci. Biobehav. Rev. 47, 646–655 (2014).
Google Scholar
Ohayon, M. M., Carskadon, M. A., Guilleminault, C. & Vitiello, M. V. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 27 (7), 1255–1273 (2004).
Google Scholar
England, L. J. et al. Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products. Neurosci. Biobehav. Rev. 72, 176–189 (2017).
Google Scholar
Levy, D. T. et al. A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products. Addict. (Abingdon England). 112 (1), 8–17 (2017).
Google Scholar
Schauer, G. L., Rosenberry, Z. R. & Peters, E. N. Marijuana and tobacco co-administration in blunts, spliffs, and mulled cigarettes: A systematic literature review. Addict. Behav. 64, 200–211 (2017).
Google Scholar
Barve, S., Chen, S. Y., Kirpich, I., Watson, W. H. & McClain, C. Development, prevention, and treatment of Alcohol-Induced organ injury: the role of nutrition. Alcohol Research: Curr. Reviews. 38 (2), 289–302 (2017).
Piano, M. R. Alcohol’s effects on the cardiovascular system. Alcohol Research: Curr. Reviews. 38 (2), 219–241 (2017).
Fernandez-Bustamante, A. & Repine, J. E. Chronic inflammatory diseases and the acute respiratory distress syndrome (ARDS). Curr. Pharm. Design. 20 (9), 1400–1408 (2014).
Google Scholar
Vrdoljak, D. et al. Lifestyle intervention in general practice for physical activity, smoking, alcohol consumption and diet in elderly: a randomized controlled trial. Arch. Gerontol. Geriatr. 58 (1), 160–169 (2014).
Google Scholar
Wilson, D. E. et al. Lifestyle factors in hypertension drug research: systematic analysis of articles in a leading Cochrane report. Int. J. Hypertens. 2014, 835716 (2014).
Google Scholar
Ricci, G., Pirillo, I., Tomassoni, D., Sirignano, A. & Grappasonni, I. Metabolic syndrome, hypertension, and nervous system injury: Epidemiological correlates. Clinical and experimental hypertension (New York, NY: 2017, 39(1):8–16. (1993).
Due, A. et al. The effect of three different ad libitum diets for weight loss maintenance: a randomized 18-month trial. Eur. J. Nutr. 56 (2), 727–738 (2017).
Google Scholar
Palacz-Poborczyk, I. & Chamberlain, K. ‘A healthy lifestyle is a journey’: exploring health perceptions and self-defined facilitators to health through photo-elicitation. 40(4):652–680. (2025).
Feng, Y. et al. Lifestyle behaviours and physical, psychological, and cognitive Multimorbidity among older hypertensive population in remote areas of China. Sci. Rep. 241, 24–32 (2025).
Jowshan, M. R., Pourjavid, A. & Amirkhizi, F. Adherence to combined healthy lifestyle and odds of metabolic syndrome in Iranian adults: the PERSIAN dena cohort study. 15(1):5164. (2025).
Qiao, L. et al. Combined healthy lifestyle behaviors and all-cause mortality risk in middle-aged and older US adults: A longitudinal cohort study. Arch. Gerontol. Geriatr. 130, 105702 (2025).
Google Scholar
Zuo, W. & Yang, X. Joint association of diet quality and physical activity with obstructive sleep apnea: A cross-sectional study. Prev. Med. 192, 108226 (2025).
Google Scholar
Yuan, Y., Tian, P., Li, L. & Qu, Q. Comparison of the associations between life’s essential 8 and life’s simple 7 with stroke: NHANES 1999–2018. J. Stroke Cerebrovasc. Diseases: Official J. Natl. Stroke Association. 34 (3), 108238 (2025).
Google Scholar
Li, Y. et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ (Clinical Res. ed). 368, l6669 (2020).
Han, H. et al. Association of a healthy lifestyle with All-Cause and Cause-Specific mortality among individuals with type 2 diabetes: A prospective study in UK biobank. 45(2):319–329. (2022).
Kaminsky, L. A. et al. The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. BMJ (Clinical Res. ed). 70, 8–15 (2022).
Zhang, Y. B. et al. Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies. 373:n604. (2021).
link
:max_bytes(150000):strip_icc()/Harvard-Developed-AHEI-Diet-Is-Better-Than-Mediterranean-FT-BLOG0525-0ac28e32d97c4b2182e89500ec56830c.jpg "This Is the Best Diet for Healthy Aging, According to Science")
