Vascular Responses to Long- and Short-Term Exposure to Fine Particulate Matter MESA Air (Multi-Ethnic Study of Atherosclerosisi and Air Pollution)

Objectives This study evaluated the association of long- and short-term air pollutant exposures with flow-mediated dilation (FMD) and baseline arterial diameter (BAD) of the brachial artery using ultrasound in a large multicity cohort. Background Exposures to ambient air pollution, especially long-term exposure to particulate matter <2.5 mu m in aerodynamic diameter (PM2.5), are linked with cardiovascular mortality. Short-term exposure to PM2.5 has been associated with decreased FMD and vasoconstriction, suggesting that adverse effects of PM2.5 may involve endothelial dysfunction. However, long-term effects of PM2.5 on endothelial dysfunction have not been investigated. Methods FMD and BAD were measured by brachial artery ultrasound at the initial examination of the Multi-Ethnic Study of Atherosclerosis. Long-term PM2.5 concentrations were estimated for the year 2000 at each participant's residence (n = 3,040) using a spatio-temporal model informed by cohort-specific monitoring. Short-term PM2.5 concentrations were based on daily central-site monitoring in each of the 6 cities. Results An interquartile increase in long-term PM2.5 concentration (3 mu g/m(3)) was associated with a 0.3% decrease in FMD (95% confidence interval [CI] of difference: -0.6 to -0.03; p = 0.03), adjusting for demographic characteristics, traditional risk factors, sonographers, and 1/BAD. Women, nonsmokers, younger participants, and those with hypertension seemed to show a greater association of PM2.5 with FMD. FMD was not significantly associated with short-term variation in PM2.5 (-0.1% per 12 mu g/m(3) daily increase [95% CI: -0.2 to 0.04] on the day before examination). Conclusions Long-term PM2.5 exposure was significantly associated with decreased endothelial function according to brachial ultrasound results. These findings may elucidate an important pathway linking air pollution and cardiovascular mortality. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487) (J Am Coll Cardiol 2012;60:2158-66) (C) 2012 by the American College of Cardiology Foundation