{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:32:12Z","timestamp":1790735532918,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Limited studies using individual\u2010level health outcome data exist from countries with a wider range of particulate matter with a diameter of &lt;2.5 \u03bcm (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ) levels to illustrate the shape of the exposure\u2013response curve across a wide PM\n                      <jats:sub>2.5<\/jats:sub>\n                      range, including &gt;15\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentrations. Taiwan reduced PM\n                      <jats:sub>2.5<\/jats:sub>\n                      over time with its policies, which provide opportunities to illustrate the dose\u2013response curves and how reductions of PM\n                      <jats:sub>2.5<\/jats:sub>\n                      over time correlated with cardiovascular events incidence in a nationwide sample.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Using data from the 2009 to 2019 Taiwan National Health Insurance Database linked to nationwide PM\n                      <jats:sub>2.5<\/jats:sub>\n                      data, we examined the magnitude of the exposure\u2013response curve between seasonal average PM\n                      <jats:sub>2.5<\/jats:sub>\n                      level and cardiovascular events\u2010related hospitalizations among older adults at high risk for cardiovascular events. We used history\u2010adjusted marginal structural models including potential confounding by individual demographic factors, baseline comorbidities, and health service measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We included 373\u2009402 older adults with high\u2010risk conditions in Taiwan. Using the PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentration &lt;15\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      (Taiwan regulatory standard) as a reference, the seasonal average PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentrations (15\u201323.5 and &gt;23.5\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      ) were associated with hazard ratio of 1.13 (95% CI, 1.09\u20131.18) and 1.19 (95% CI, 1.14\u20131.24), 1.07 (95% CI, 1.03\u20131.11) and 1.14 (95% CI, 1.10\u20131.18), 1.22 (95% CI, 1.08\u20131.38) and 1.31 (95% CI, 1.16\u20131.48), 1.04 (95% CI, 0.98\u20131.10) and 1.10 (95% CI, 1.04\u20131.16), respectively, for heart failure, ischemic stroke\/transient ischemic attack, deep vein thrombosis, and myocardial infarction\/acute coronary syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Further lowering PM\n                      <jats:sub>2.5<\/jats:sub>\n                      levels beyond current regulatory standards (15\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      ) may effectively reduce the incidence of heart failure, deep vein thrombosis, and ischemic stroke\/transient ischemic attack, and can lead to tangible health benefits in the high\u2010risk older population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043306","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T11:00:40Z","timestamp":1765450840000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Exposure\u2013Response to High PM\n                    <sub>2.5<\/sub>\n                    Levels for Cardiovascular Events in High\u2010Risk Older Adults in Taiwan"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8934-4542","authenticated-orcid":false,"given":"Shu\u2010Ping","family":"Huang","sequence":"first","affiliation":[{"name":"Changhua Christian Hospital","place":["Changhua, Taiwan"]},{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5046-125X","authenticated-orcid":false,"given":"Chien\u2010Chou","family":"Su","sequence":"additional","affiliation":[{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan\u2010Yao","family":"Lin","sequence":"additional","affiliation":[{"name":"Academia Sinica","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9895-1477","authenticated-orcid":false,"given":"Rachel","family":"Nethery","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2490-6272","authenticated-orcid":false,"given":"Kevin","family":"Josey","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-4028","authenticated-orcid":false,"given":"Benjamin","family":"Bates","sequence":"additional","affiliation":[{"name":"Rutgers University Institute for Health, Healthcare Policy, and Aging Research","place":["New Brunswick, USA"]},{"name":"Department of Medicine, Rutgers Robert Wood Johnson Medical School, One Robert Wood Johnson Pl.","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2954-3717","authenticated-orcid":false,"given":"David","family":"Robinson","sequence":"additional","affiliation":[{"name":"Rutgers University","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0939-829X","authenticated-orcid":false,"given":"Poonam","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Rutgers University Institute for Health, Healthcare Policy, and Aging Research","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8597-6392","authenticated-orcid":false,"given":"Melanie","family":"Rua","sequence":"additional","affiliation":[{"name":"Rutgers University Institute for Health, Healthcare Policy, and Aging Research","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwaghosha","family":"Parthasarathi","sequence":"additional","affiliation":[{"name":"Rutgers University Institute for Health, Healthcare Policy, and Aging Research","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1583-752X","authenticated-orcid":false,"given":"Soko","family":"Setoguchi","sequence":"additional","affiliation":[{"name":"Rutgers University Institute for Health, Healthcare Policy, and Aging Research","place":["New Brunswick, USA"]},{"name":"Department of Medicine, Rutgers Robert Wood Johnson Medical School, One Robert Wood Johnson Pl.","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4623-5561","authenticated-orcid":false,"given":"Yea\u2010Huei","family":"Kao Yang","sequence":"additional","affiliation":[{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]},{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2020.105974"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.17923"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1702747"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvaa025"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11869-019-00785-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.03.017"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12940-020-00575-0"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12940-021-00742-x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aba5692"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2018.05.181"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181dbece1"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.10.1127"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319844"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1103639"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12940-019-0506-2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12302-022-00634-y"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(23)00047-5"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.784800"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/atmos11060589"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwad089"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1289\/EHP44"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S196293"},{"key":"e_1_3_2_24_2","first-page":"347","article-title":"Using regional differences and demographic characteristics to evaluate the principles of estimation of the residence of the population in National Health Insurance Research Databases (NHIRD)","volume":"30","author":"Lin MH","year":"2011","unstructured":"Lin MH, Yang AC, Wen T\u2010H. 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