Table 23. Long-term effects of air pollution on CVD incidence and mortality.

Study region	Mean exposure values of ambient air pollutants, μg/m3	Sample size	Follow-up time	Outcome indicator	Increased risk for every 10 μg/m3 increase in annual mean concentration (95% CI)
aHR is calculated based on per IQR increase. Value of per IQR for PM2.5, SO42-, NH4+, NO3- and BC is 27.9, 5.67, 4.44, 8.92 and 2.28 μg/m3, respectively. bHR is calculated based on per IQR increase. Value of per IQR for PM2.5, PM10 and NO2 is 5.92, 11.34 and 6.17 μg/m3, respectively. cHR is calculated based on per IQR increase. Value of per IQR for PM2.5, SO2, NOX, NO2, O3 and CO is 9.6 μg/m3, 2.4 part per billion (ppb), 14.5 ppb, 9 ppb, 6.5 ppb and 0.2 part per million (ppm), respectively. dHR is calculated by Q4 vs. Q1. CVD: cardiovascular disease; PAU: provincial administrative unit.
15 PUAs in China (China-PAR)[165]	PM2.5 64.9	117,575	2000 –2015	Stroke incidence	Total strokes 13% (95% CI: 9%–17%) Ischemic stroke 20% (95% CI: 15%–25%) Hemorrhagic stroke 12 % (95% CI: 5%–20%)
15 PUAs in China (China-PAR)[ 160]	PM2.5 67.4	116,972	2000–2015	CVD incidence and death	CVD incidence 25% (95% CI: 22%–28%) CVD death 16% (95% CI: 12 %–21%)
15 PUAs in China (China-PAR)[167]	PM2.5 64.96	118,229	2000–2015	Fatal and nonfatal CAD incidence	Total CAD 43% (35%–51%) Fatal CAD 38% (25%–53%) Nonfatal CAD 45% (36%–56%)
15 PUAs in China (China-PAR)[ 158] 161 counties in China[ 161]	PM2.5 64.9 PM2.5 46	116,821 90,672	2000–2015 2010–2017	All-cause death CVD death	11% (95% CI: 8%–14%) Total CVD death 2% (95% CI: 0%–5%); IHD death 5% (95% CI: 1%–9%); Total stroke death 3% (95% CI: 0–6%); Ischemic stroke death 1% (95% CI: 4%–19%)
162 counties in 25 PUAs[ 162]	PM2.5: 47.6; BC: 3.1; OM: 9.0; NO3-: 10.2; NH4+: 7.1; SO42-: 11.2;	14,331	2010–2017	Total CVD and hypertension incidence	aTotal CVD incidence: PM2.5: 29.1% (95% CI: 14.7%–45.4%); SO42-: 72.1% (95% CI: 51.7%–95.1%); NH4+: 53.7% (95 % CI: 34.1%–76.2%); NO3-: 31.1% (95% CI: 12.8%–52.3%); BC: 29.4 (95% CI: 15.8%–44.6%) aHypertension incidence: PM2.5: 32.6% (95 % CI: 15.1%–52.8%)
Ningbo[166]	PM2.5: 34.56; PM10: 50.88; NO2: 31.66	29,141	2015–2018	IHD incidence	bPM2.5: 21% (95% CI: 10%–33%); bPM10:12% (95% CI: 3%–22%); bNO2: 9% (95% CI: 2%–16%)
Taiwan[ 159]	PM2.5: 26.2	400,459	2001–2019	All-cause death and CVD death	All-cause death 29% (95% CI: 24%–35%) CVD death 42% (95% CI: 29%–57%)
Taiwan[164]	PM2.5: 30.4 (2010) 21.1 (2015)	1,362,284	2011–2016	Stroke incidence	cTotal strokes PM2.5: 3% (95% CI: 1%–5%) SO2: 3% (95% CI: 2%–5%) NOX: 4% (95% CI: 2%–5%) NO2: 4% (95% CI: 2%–7%) CO: 3% (95% CI: 1% –4%); cIschemic stroke
Taiwan[168]	PM2.5: (Q1–Q4) < 28.24, 28.24–31.46, 31.46–38.47, ≥ 38.47 μg/m3/day; NO2: (Q1– Q4) < 16.14, 16.14–20.49, 20.49–24.90, ≥ 24.90 ppb/day; CO: (Q1–Q4) < 0.47, 0.47–0.58, 0.58–0.68, ≥ 0.68 ppm/day	100,138	2003–2013	Peripheral arterial occlusive disease incidence	PM2.5: 5% (95% CI: 3%–8%) SO2: 5% (95% CI: 3%–7%) NOX: 4% (95% CI: 2%–6%) NO2: 5% (95% CI: 3%–8%) CO: 3% (95% CI: 1%–4%); cHemorrhagic stroke NOX: 4% (95% CI: 0–7%) CO: 3% (95% CI: 0–5%) dPM2.5: 14% (95% CI: 13%–16%) dNO2: 3% (95% CI: 2%–4%) dCO: 135% (95% CI: 95%–184%)