Abstract
Air and noise pollution are recognized public health concerns. However, their long-term impact on valvular heart disease (VHD) remains unclear. This study analyzed 453,413 participants from the UK Biobank. Air pollution was quantified using the air pollution score based on PM2.5, PM2.5-10, PM10, NOx, and NO2 levels. Road traffic noise (Lden and Lnight) exposure was estimated based on baseline residential addresses. Participants were categorized into quintiles (Q1-Q5) of exposure. VHD diagnoses were identified from hospitalization and cause-of-death records. Multivariable Cox proportional hazard models were used to assess the association between pollution exposures and VHD risk, presented as hazard ratios (HR) with 95 % confidence intervals (CI). During a median follow-up of 13.9 years, 18,506 cases of VHD were recorded. Participants exposed to the highest levels of pollution exposures had a significantly increased risk of developing VHD compared to those in the lowest exposure group (Q5 vs. Q1: air pollution score [HR 1.73, 95 % CI 1.61-1.87], PM2.5 [HR 1.69, 95 % CI 1.57-1.82], PM2.5-10 [HR 1.43, 95 % CI 1.34-1.53], PM10 [HR 1.29, 95 % CI 1.22-1.36], NO2 [HR 1.59, 95 % CI 1.47-1.71], NOX [HR 1.64, 95 % CI 1.53-1.77], Lden [HR 1.66, 95 % CI 1.56-1.77], and Lnight [HR 1.67, 95 % CI 1.57-1.78]). These associations persisted significantly regardless of the genetic risk to VHD and extended across all VHD subtypes, including non-rheumatic, rheumatic, aortic, mitral, tricuspid, and pulmonary valve diseases. This study demonstrates a significantly positive association between long-term exposure to air and noise pollution and increased VHD risk.</p>