Associations Between Residential Proximity to Traffic and Vascular Disease in a Cardiac Catheterization Cohort
Citation:
Ward-Caviness, C., W. Kraus, C. Blach, C. Haynes, E. Dowdy, M. Miranda, R. Devlin, D. Diaz-Sanchez, W. Cascio, S. Mukerjee, C. Stallings, L. Smith, S. Gregory, S. Shah, L. Neas, AND E. Hauser. Associations Between Residential Proximity to Traffic and Vascular Disease in a Cardiac Catheterization Cohort. Arteriosclerosis, Thrombosis, and Vascular Biology. Lippincott Williams & Wilkins, Philadelphia, PA, 38(1):275-282, (2018).
Impact/Purpose:
Cardiovascular disease accounts for about a third of all U.S. deaths. Nearly 800,000 Americans die each year due to heart disease, stroke and other cardiovascular diseases. The study finds that exposure to traffic-related pollution is associated with peripheral artery disease and high blood pressure in people at high risk for heart disease. The findings corroborate other research indicating that living near major roadways increases the risk of cardiovascular disease.
Description:
Objective: Exposure to mobile source emissions is nearly ubiquitous in developed nations, and is associated with multiple adverse health outcomes. There is an ongoing need to understand the specificity of traffic exposure associations with vascular outcomes, particularly in individuals with cardiovascular disease. Approach and Results: We performed a cross-sectional study using 2,124 individuals residing in North Carolina, USA who received a cardiac catheterization at the Duke University Medical Center. Traffic-related exposure was assessed via two metrics: 1) the distance between the primary residence and the nearest major roadway; and 2) location of the primary residence in regions defined based on local traffic patterns. We examined four cardiovascular disease outcomes: hypertension, peripheral arterial disease (PAD), the number of diseased coronary vessels, and recent myocardial infarction (MI). Statistical models were adjusted for race, sex, smoking, type 2 diabetes, body mass index, hyperlipidemia, and home value. Results are expressed in terms of the odds ratio (OR). A 23% decrease in residential distance to major roadways was associated with higher prevalence of PAD (OR = 1.29; 95% confidence interval, 1.08–1.55) and hypertension (OR = 1.15; 95% confidence interval, 1.01–1.31). Associations with PAD were strongest in men (OR = 1.42; 95% confidence interval, 1.17–1.74) while associations with hypertension were strongest in women (OR = 1.21; 95% confidence interval, 0.99–1.49). Neither MI nor the number of diseased coronary vessels were associated with traffic exposure. Conclusions: Traffic-related exposure is associated with PAD and hypertension, while no associations are observed for two coronary-specific vascular outcomes.
