Introduction: Atmospheric particulate matter (PM) has been associated with increased risks for heart failure (HF). However, the individual susceptibility to PM might vary, given the discrepancies in the underline morbidities.
Hypothesis: We hypothesized that the influence of PM on HF hospitalization was varied in subjects with different morbidities.
Methods: Subjects who resided around the air quality monitoring stations within a radius of 2 kilometers were identified from the National Health Insurance Dataset. The concentrations of PM2.5 and PM10, and the temperature were measured hourly from 1997 to 2012. Case-crossover design and conditional logistic regression were used to evaluate the impact of particulate matter on HF hospitalization. The temperature, the daily temperature change, and their interaction effect were also evaluated in multivariable models.
Results: Among a total of 117 728 HF hospitalization events were identified between 1997 and 2012. An averaged daily PM10 concentration of ≥70 PPM was significantly related to an additional risk of 2.9% for HF hospitalization (odds ratio and 95% confidence intervals: 1.029;1.003-1.056), and a PM2.5 of ≥70 PPM was associated with an excessive 8.0% of HF hospitalization (1.080;1.029-1.113). Among the hypertensive subjects (n=100,831), a significant dose-response relation between PM2.5 and HF hospitalizations was observed [1.028;1.003-1.053 and 1.098;1.042-1.156 for the PM2.5 of 35-70 and ≥70 PPM, respectively) In subjects with diabetes (n=60,488), the associations remained true that the risks of HF hospitalizations significantly increased by 2.9% and 13.6% as the PM2.5 concentrations of 35-70 and ≥70 PPM, respectively. Furthermore, the risks of HF hospitalizations were even higher in subjects with both hypertension and diabetes (n=38,210) (1.172;1.020-1.347 and 1.049;0.971-1.134 for PM2.5 and PM10 of ≥70 PPM, respectively.
Conclusions: PM2.5 and PM10 were associated with increased risks of HF hospitalization. The risks were even higher in subjects with hypertension, diabetes.