Abstract
BACKGROUND: Air pollution is a known contributor to cardiovascular disease (CVD) and CVD death. However, the potential role of nighttime light (NTL) in the relationship between ambient air pollution and CVD risk remains uncertain. METHODS: In this prospective cohort study, we analyzed data from 416 032 participants in the UKB (UK Biobank) to investigate the relationships among air pollution, NTL, and CVD. Air pollution levels were assessed using latent profile analysis to capture joint exposure to multiple types of pollution. Cox proportional hazards regression models were used to estimate the associations between individual and joint exposures to air pollution and CVD. The role of NTL was explored through joint and mediation analyses. RESULTS: Individual and joint air pollution levels were significantly associated with increased CVD risk. Specifically, individuals exposed to severe levels of air pollution had higher hazard ratios for coronary heart disease, heart failure, arrhythmia, all-cause CVD death, and stroke: 1.071 (95% CI, 1.022-1.121), 1.318 (95% CI, 1.218-1.427), 1.067 (95% CI, 1.016-1.121), 1.253 (95% CI, 1.117-1.406), and 1.057 (95% CI, 1.005-1.111), respectively. Joint analysis of air pollution and NTL revealed a stepwise increase in CVD risk with increasing exposure levels. Mediation analysis indicated that NTL mediated 24.80% of the effect of air pollution on coronary heart disease and between 20.04% and 39.24% of the effect on heart failure across exposure levels. CONCLUSIONS: Our findings indicate positive associations of both air pollution and NTL with CVD, with NTL partially mediating the relationships between air pollution and risks of coronary heart disease and heart failure.