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Despite their ability to penetrate deep into the respiratory system, their harmfulness remains insufficiently studied, primarily due to the lack of reliable standardised and harmonized long\u2010term global exposure data. In this study, we applied an ecological approach to provide an exploratory assessment of the long\u2010term exposure to UFPs from 2010 to 2019 in high\u2010income countries (HICs) in relation to cardiovascular disease (CVD) risk using publicly available country\u2010level aggregate data. To minimize social and demographic confounding factors and use reliable UFP estimation, we focus exclusively on HICs and the findings should not be generalized globally. Using a newly developed global UFP data set, we estimated population\u2010weighted exposure (PWE) over the past decade. These estimates were combined with CVD aggregate data to identify statistically significant co\u2010occurrences between PWE of UFPs and three health outcomes: disability\u2010adjusted life years (DALYs), years of life lost (YLLs), and years of life lived with disability (YLDs). The findings suggest consistent patterns between long\u2010term exposures to UFPs and CVDs. Aligning with the current literature, we suggest that further research into possible effects on CVDs due to long\u2010term UFPs exposure is needed. Coherent with the last EU directives, our findings highlight the relevance of monitoring UFPs as a public health priority even when  mass\u2010based standards are met. While our conclusions are limited to group level associations, our ecological analysis could serve as a preliminary step toward establishing consistent UFP exposure\u2010response relationships.<\/jats:p>","DOI":"10.1029\/2025gh001636","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:24:24Z","timestamp":1785284664000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes of Long\u2010Term Exposure to Ultrafine Particles From 2010 to 2019 in High Income Countries in Relation to Cardiovascular Diseases"],"prefix":"10.1029","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9590-3776","authenticated-orcid":false,"given":"F.","family":"Costabile","sequence":"first","affiliation":[{"name":"CNR\u2010ISAC  Rome Italy"},{"name":"Max Planck Institute for Chemistry  Mainz 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