Abstract
IMPORTANCE: Light at night causes circadian disruption, which is a known risk factor for adverse cardiovascular outcomes. However, it is not well understood of cardiovascular diseases. OBJECTIVE: To assess whether day and night light exposure is associated with incidence of cardiovascular diseases, and whether associations of light with cardiovascular diseases differ according to genetic susceptibility, sex, and age. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study analyzed cardiovascular disease records across 9.5 years (June 2013 to November 2022) from UK Biobank participants who wore light sensors in a naturalistic setting. Data were analyzed from September 2024 to July 2025. EXPOSURE: Approximately 13 million hours of light exposure data, tracked by wrist-worn light sensors (1 week each), categorized into the 0 to 50th, 51st to 70th, 71st to 90th, and 91st to 100th percentiles. MAIN OUTCOMES AND MEASURES: Incidence of coronary artery disease, myocardial infarction, heart failure, atrial fibrillation, and stroke after light tracking were derived from UK National Health Service records. Risks of cardiovascular diseases were assessed using Cox proportional hazards models (3 primary models adjusted at 3 levels) and reported as hazard ratios (HRs). RESULTS: A total of 88 905 individuals were included (mean [SD] age, 62.4 [7.8] years; 50 577 female [56.9%]). Compared with individuals with dark nights (0-50th percentiles), those with the brightest nights (91st-100th percentiles) had significantly higher risks of developing coronary artery disease (adjusted HR [aHR], 1.32; 95% CI, 1.18-1.46), myocardial infarction (aHR, 1.47; 95% CI, 1.26-1.71), heart failure (aHR, 1.56; 95% CI, 1.34-1.81), atrial fibrillation (aHR, 1.32; 95% CI, 1.18-1.46), and stroke (aHR, 1.28; 95% CI, 1.06-1.55). These associations were robust after adjusting for established cardiovascular risk factors, including physical activity, smoking, alcohol, diet, sleep duration, socioeconomic status, and polygenic risk. Larger-magnitude associations of night light with risks of heart failure (P for interaction = .006) and coronary artery disease (P for interaction = .02) were observed for females, and larger-magnitude associations of night light with risks of heart failure (P for interaction = .04) and atrial fibrillation (P for interaction = .02) were observed for younger individuals in this cohort. CONCLUSIONS AND RELEVANCE: In this cohort study, night light exposure was a significant risk factor for developing cardiovascular diseases among adults older than 40 years. These findings suggest that, in addition to current preventive measures, avoiding light at night may be a useful strategy for reducing risks of cardiovascular diseases.