{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:54:29Z","timestamp":1787115269395,"version":"build-2736575974"},"reference-count":44,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81671379"],"award-info":[{"award-number":["81671379"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017958","name":"Health Commission of Hubei Province","doi-asserted-by":"publisher","award":["WJ2019Z016"],"award-info":[{"award-number":["WJ2019Z016"]}],"id":[{"id":"10.13039\/100017958","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Commission of Guangdong Province","award":["B2019196"],"award-info":[{"award-number":["B2019196"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2022,9,21]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite ambient air pollution being associated with various adverse cardiovascular outcomes, the acute effects of ambient air pollution on hospital readmissions for heart failure (HF) among post-discharge patients with hypertension remain less understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a time-stratified case-crossover study among 3660 subjects 60 years or older who were admitted to hospital for HF after discharge for hypertension in Guangzhou, China during 2016\u20132019. For each subject, individualised residential exposures to ambient particulate matter with an aerodynamic diameter \u22641 \u00b5m (PM<jats:sub>1<\/jats:sub>), \u22642.5 \u00b5m (PM<jats:sub>2.5<\/jats:sub>), \u226410 \u00b5m (PM<jats:sub>10<\/jats:sub>), sulfur dioxide (SO<jats:sub>2<\/jats:sub>), nitrogen dioxide (NO<jats:sub>2<\/jats:sub>), carbon monoxide (CO) and ozone were extracted from our validated grid dataset.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>An IQR increase of lag 04-day exposure to PM<jats:sub>1<\/jats:sub> (IQR: 11.6 \u03bcg\/m<jats:sup>3<\/jats:sup>), PM<jats:sub>2.5<\/jats:sub> (IQR 21.9 \u03bcg\/m<jats:sup>3<\/jats:sup>), PM<jats:sub>10<\/jats:sub> (IQR 35.0 \u03bcg\/m<jats:sup>3<\/jats:sup>), SO<jats:sub>2<\/jats:sub> (IQR 4.4 \u03bcg\/m<jats:sup>3<\/jats:sup>), NO<jats:sub>2<\/jats:sub> (IQR 23.3 \u03bcg\/m<jats:sup>3<\/jats:sup>) and CO (IQR 0.25 mg\/m<jats:sup>3<\/jats:sup>) was significantly associated with a 9.77% (95% CI 2.21% to 17.89%), 8.74% (95% CI 1.05% to 17.00%), 13.93% (95% CI 5.36% to 23.20%), 10.81% (95% CI 1.82% to 20.60%), 14.97% (95% CI 8.05% to 22.34%) and 7.37% (95% CI 0.98% to 14.16%) increase in odds of HF readmissions, respectively. With adjustment for other pollutants, the association for NO<jats:sub>2<\/jats:sub> exposure remained stable, while the associations for PM<jats:sub>1<\/jats:sub>, PM<jats:sub>2.5<\/jats:sub>, PM<jats:sub>10<\/jats:sub>, SO<jats:sub>2<\/jats:sub> and CO exposures became insignificant. Overall, an estimated 19.86% of HF readmissions were attributable to NO<jats:sub>2<\/jats:sub> exposure, while reducing NO<jats:sub>2<\/jats:sub> exposure to the WHO and China air quality standards would avoid 12.87% and 0.54% of readmissions, respectively. No susceptible populations were observed by sex, age or season.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Short-term exposure to ambient NO<jats:sub>2<\/jats:sub> was significantly associated with an increased odds of HF readmissions among post-discharge patients with hypertension in older Chinese adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2022-219676","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T13:21:31Z","timestamp":1664976091000},"page":"984-990","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Short-term exposure to ambient air pollution and readmissions for heart failure among 3660 post-discharge patients with hypertension in older Chinese adults"],"prefix":"10.1136","volume":"76","author":[{"given":"Ruijun","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland at College Park, College Park, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunshao","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingxin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoxuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Statistics, Guangzhou Health Technology Identification and Human Resources Assessment Center, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiang","family":"Shi","sequence":"additional","affiliation":[{"name":"Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Hypertension and Vascular Disease, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-4262","authenticated-orcid":false,"given":"Yuewei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"2025100702131950000_76.12.984.1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","year":"2021","journal-title":"Lancet"},{"key":"2025100702131950000_76.12.984.2","doi-asserted-by":"crossref","DOI":"10.1007\/s11886-015-0648-y","article-title":"An update on inpatient hypertension management","volume":"17","author":"Axon","year":"2015","journal-title":"Curr Cardiol Rep"},{"key":"2025100702131950000_76.12.984.3","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"2025100702131950000_76.12.984.4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1161\/HYPERTENSIONAHA.118.11691","article-title":"Thirty-day readmissions after hospitalization for hypertensive emergency","volume":"73","author":"Kumar","year":"2019","journal-title":"Hypertension"},{"key":"2025100702131950000_76.12.984.5","doi-asserted-by":"crossref","unstructured":"Ge J , Cui X , Hu K . Current status of heart failure in China. Cardiol Plus 2017;2.doi:10.4103\/2470-7511.248468","DOI":"10.4103\/2470-7511.248468"},{"key":"2025100702131950000_76.12.984.6","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1038\/s41371-021-00570-z","article-title":"Hypertension in China: burdens, guidelines and policy responses: a state-of-the-art review","volume":"36","author":"Yin","year":"2022","journal-title":"J Hum Hypertens"},{"key":"2025100702131950000_76.12.984.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2010.08.010"},{"key":"2025100702131950000_76.12.984.8","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1093\/inthealth\/ihz078","article-title":"Air pollution: the emergence of a major global health risk factor","volume":"11","author":"Boogaard","year":"2019","journal-title":"Int Health"},{"key":"2025100702131950000_76.12.984.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60898-3"},{"key":"2025100702131950000_76.12.984.10","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31824d5a85"},{"key":"2025100702131950000_76.12.984.11","first-page":"579","article-title":"Chinese guidelines for the management of hypertension","volume":"2011","author":"Liu","year":"2010","journal-title":"Chin J Hypertens"},{"key":"2025100702131950000_76.12.984.12","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115853"},{"key":"2025100702131950000_76.12.984.13","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.jacc.2020.11.033","article-title":"Short-term exposure to ambient air pollution and mortality from myocardial infarction","volume":"77","author":"Liu","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025100702131950000_76.12.984.14","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1164\/rccm.201810-1823OC","article-title":"Short-term exposure to ambient air pollution and asthma mortality","volume":"200","author":"Liu","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2025100702131950000_76.12.984.15","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.0901485"},{"key":"2025100702131950000_76.12.984.16","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg246"},{"key":"2025100702131950000_76.12.984.17","doi-asserted-by":"crossref","DOI":"10.1016\/j.rse.2021.112775","article-title":"Full-coverage mapping and spatiotemporal variations of ground-level ozone (O3) pollution from 2013 to 2020 across China","volume":"270","author":"Wei","year":"2022","journal-title":"Remote Sens Environ"},{"key":"2025100702131950000_76.12.984.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.envint.2020.106290","article-title":"The ChinaHighPM10 dataset: generation, validation, and spatiotemporal variations from 2015 to 2019 across China","volume":"146","author":"Wei","year":"2021","journal-title":"Environ Int"},{"key":"2025100702131950000_76.12.984.19","doi-asserted-by":"crossref","DOI":"10.1016\/j.rse.2020.112136","article-title":"Reconstructing 1-km-resolution high-quality PM2.5 data records from 2000 to 2018 in China: spatiotemporal variations and policy implications","volume":"252","author":"Wei","year":"2021","journal-title":"Remote Sens Environ"},{"key":"2025100702131950000_76.12.984.20","doi-asserted-by":"crossref","first-page":"13265","DOI":"10.1021\/acs.est.9b03258","article-title":"Satellite-derived 1-km-resolution PM\n                  1\n                concentrations from 2014 to 2018 across China","volume":"53","author":"Wei","year":"2019","journal-title":"Environ Sci Technol"},{"key":"2025100702131950000_76.12.984.21","doi-asserted-by":"crossref","first-page":"9988","DOI":"10.1021\/acs.est.2c03834","article-title":"Ground-level NO\n                  2\n                surveillance from space across China for high resolution using interpretable spatiotemporally weighted artificial intelligence","volume":"56","author":"Wei","year":"2022","journal-title":"Environ Sci Technol"},{"key":"2025100702131950000_76.12.984.22","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1007\/s13351-019-9067-0","article-title":"Improving land surface hydrological simulations in China using CLDAS meteorological forcing data","volume":"33","author":"Liu","year":"2019","journal-title":"J Meteorol Res"},{"key":"2025100702131950000_76.12.984.23","doi-asserted-by":"crossref","DOI":"10.1016\/j.envint.2019.105364","article-title":"Association between ambient temperature and semen quality: a longitudinal study of 10 802 men in China","volume":"135","author":"Zhou","year":"2020","journal-title":"Environ Int"},{"key":"2025100702131950000_76.12.984.24","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000181315.18836.9d"},{"key":"2025100702131950000_76.12.984.25","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1111\/ene.15343","article-title":"Association of short-term exposure to ambient air pollution with mortality from ischemic and hemorrhagic stroke","volume":"29","author":"Xu","year":"2022","journal-title":"Eur J Neurol"},{"key":"2025100702131950000_76.12.984.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7382.219"},{"key":"2025100702131950000_76.12.984.27","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.envres.2008.07.024","article-title":"Air pollution and hospital admissions for congestive heart failure: are there potentially sensitive groups?","volume":"108","author":"Lee","year":"2008","journal-title":"Environ Res"},{"key":"2025100702131950000_76.12.984.28","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi135"},{"key":"2025100702131950000_76.12.984.29","first-page":"1462","article-title":"Hospitalization for uncomplicated hypertension: an ambulatory care sensitive condition","volume":"29","author":"Walker","year":"2013","journal-title":"Can J Cardiol"},{"key":"2025100702131950000_76.12.984.30","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1164\/rccm.201904-0834ED","article-title":"Traffic-related air pollution, health, and allergy: the role of nitrogen dioxide","volume":"200","author":"Bosson","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2025100702131950000_76.12.984.31","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200101000-00010"},{"key":"2025100702131950000_76.12.984.32","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200201000-00014"},{"key":"2025100702131950000_76.12.984.33","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.amjcard.2017.11.039","article-title":"Effect of ambient air pollution on hospitalization for heart failure in 26 of China's largest cities","volume":"121","author":"Liu","year":"2018","journal-title":"Am J Cardiol"},{"key":"2025100702131950000_76.12.984.34","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph15102217","article-title":"Association between PM\n                  2.5\n                and daily hospital admissions for heart failure: a time-series analysis in Beijing","volume":"15","author":"Li","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"2025100702131950000_76.12.984.35","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1590\/S1413-81232011000400021","article-title":"A growing role for gender analysis in air pollution epidemiology","volume":"16","author":"Clougherty","year":"2011","journal-title":"Cien Saude Colet"},{"key":"2025100702131950000_76.12.984.36","doi-asserted-by":"publisher","DOI":"10.1063\/1.368615"},{"key":"2025100702131950000_76.12.984.37","doi-asserted-by":"publisher","DOI":"10.1126\/scisignal.3143pe36"},{"key":"2025100702131950000_76.12.984.38","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.7523"},{"key":"2025100702131950000_76.12.984.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2014.05.013"},{"key":"2025100702131950000_76.12.984.40","doi-asserted-by":"crossref","first-page":"28","DOI":"10.2174\/1381612822666151109111712","article-title":"Air pollution exposure and blood pressure: an updated review of the literature","volume":"22","author":"Giorgini","year":"2016","journal-title":"Curr Pharm Des"},{"key":"2025100702131950000_76.12.984.41","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-04-343111"},{"key":"2025100702131950000_76.12.984.42","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1817364"},{"key":"2025100702131950000_76.12.984.43","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6572"},{"key":"2025100702131950000_76.12.984.44","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/aje\/kwaa020","article-title":"Things don't always go as expected: the example of nondifferential misclassification of exposure-bias and error","volume":"189","author":"Whitcomb","year":"2020","journal-title":"Am J Epidemiol"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2022-219676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T09:13:34Z","timestamp":1759828414000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2022-219676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,5]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,11,10]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/jech-2022-219676"],"URL":"https:\/\/doi.org\/10.1136\/jech-2022-219676","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,5]]}}}