Heart failure & cardiomyopathiesCohort study
Long-Term Wildfire Smoke Exposure and Increased Risk of Heart Failure in Older Adults
- Retrospective cohort study
Authors' conclusion
In this national cohort, long-term exposure to fire smoke-related PM2.5 was linked to a higher risk of HF compared with nonsmoke PM2.5, with greater susceptibility in women and socially vulnerable populations.
Study context
- Population
- Older adults, Medicare fee-for-service beneficiaries, contiguous US, 2007–2018
- Participants
- approximately 22 million adults · 115 million person-years
- Exposure
- Long-term wildfire smoke PM2.5 vs nonfire PM2.5 exposure
- Outcome
- Incident HF
Main finding
As reported in the abstract
Incident HF per 1-μg/m3 increase in past 2-year average PM2.5
Smoke PM2.5
0.51
mean · μg/m3
Hazard ratio (95% CI)
Smoke PM2.5per 1-μg/m3 increase in smoke PM2.5
1.014(1.007–1.020)
Nonsmoke PM2.5per 1-μg/m3 increase in nonsmoke PM2.5
1.005(1.003–1.006)
Each row per its own increment, as printed
- Estimated additional heart failure (HF) cases annually among US older adults
- 20,238 (95% CI: 10,727-29,612)
Observational data: associations, not effects.
Further findings
Days exposed to smoke PM2.5 >1 μg/m3 and >2.5 μg/m3 over past 2 years
- Both significantly associated with elevated HF risk
Smoke PM2.5 and HF, by subgroup
- Stronger association in women, Medicaid-eligible individuals and those in lower income areas
Original publication
Long-Term Wildfire Smoke Exposure and Increased Risk of Heart Failure in Older Adults. J Am Coll Cardiol. Published 1 July 2025. doi:10.1016/j.jacc.2025.04.058
Summarised from the published abstract; every number is checked against it