Global cardiovascular disease burden attributable to particulate matter pollution, 1990–2021: an analysis of the global burden of disease study 2021 and forecast to 2045

This study aims to analyze the global trends and projected burden of cardiovascular diseases (CVD) attributable to particulate matter (PM) pollution. The objectives are to assess spatiotemporal trends, socio-demographic variations, and gender differences and to forecast the future burden using data from the Global Burden of Disease (GBD) 2021 study.

We utilized data from GBD 2021 to evaluate age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) of CVD attributable to PM from 1990 to 2021. Age-period-cohort models and Joinpoint regression analysis were employed to evaluate temporal trends. The Bayesian age-period-cohort (BAPC) model, which incorporates prior information to improve prediction stability, was selected to project the future burden up to 2045 due to its robustness in handling long-term epidemiological trends.

Between 1990 and 2021, global number of deaths and DALYs for CVD attributed to PM increased by 91.68% and 78.89%, respectively. Despite these increases, ASMR and age-standardized DALYs rates declined significantly, especially among females. The burden disproportionately affected low- and middle- Socio-demographic Index (SDI) regions, with significant gender and age differences. The elderly population and regions with lower SDI will bear the greater burden. Predictions indicate that by 2045, the number of deaths and DALYs will increase by approximately three times, with females experiencing a more pronounced rise.

The study emphasizes that despite improvements in age-standardized rates, the global burden of CVD attributable to PM has significantly increased. Due to population aging, uneven regional progress, and persistent exposure to PM, targeted intervention measures and enhanced air quality regulations are needed to reduce future health impacts. These findings provide critical insights for global health policies and strategies.