Estimates, temporal evolution, and drivers of the global burden of cardiovascular disease attributable to particulate matter air pollution, 1990–2021: A systematic analysis from the global burden of disease study 2021

Cardiovascular diseases (CVDs) are the most common non-communicable diseases worldwide. Fine particulate matter (PM_2.5) has emerged as a significant modifiable risk factor contributing to the burden of CVDs. This study examines the global burden of CVDs attributable to PM_2.5 pollution from 1990 to 2021. Using data from the Global Burden of Disease (GBD) study. We calculated the estimated annual percentage change (EAPC) via log-linear regression and assessed age-standardized rates (ASRs, per 100,000 population) for deaths and disability-adjusted life years (DALYs). While global ASRs for PM_2.5-related DALYs declined from 2009.92 to 1161.77 per 100,000, these reductions were unequal: high-income regions, such as North America and Western Europe, achieved substantial progress, whereas low-income regions, particularly Sub-Saharan Africa and South Asia, faced rising burdens from PM_2.5 exposure. The study highlights the shift from household to ambient sources of PM_2.5 as the main contributor to CVDs, particularly in rapidly industrializing regions, with the total DALYs attributable to PM_2.5 increasing from 78.87 million in 1990–99.64 million in 2021. Decomposition analysis identifies population growth, aging, and epidemiological changes as key drivers of the global trends. This study provides evidence-based guidance for the CVDs prevention and PM_2.5 air pollution policy.