Short-Term Exposure to Air Pollution Increases Mortality From Hypertension and its Multiorgan Complications: A Case Crossover Study of 2.1 Million Deaths in China
Authors' conclusion
Air pollution acts as an acute stressor superimposed on hypertensive patients, creating a mortality risk gradient determined by the severity of comorbidity.
Study context
- Population
- Hypertension-related deaths across mainland China, 2013–2019
- Participants
- >2.1 million hypertension-related deaths
- Comparison
- Short-term air pollution exposure (PM2.5, PM10, NO2, O3) across hypertensive disease progression stages
- Outcome
- Hypertension mortality risk per IQR increase in air pollutants
- Follow-up
- Lag 02 days (average of lag 0-2 days)
Methodological detailsnationwide, individual-level, time-stratified
- Nationwide
- Individual-level
- Time-stratified
Main finding
As reported in the abstract
Mortality risk per IQR increase in PM2.5
Further findings
- Deaths attributable to PM2.5 (cardiorenal failure phenotype) · highest attributable fraction — Hypertensive heart and kidney disease with cardiorenal failure
- 4.20% (95% CI 3.55%–4.85%)
Pollutant comparison
- NO2 consistently showed the strongest associations among 4 air pollutants
Exposure-response curves
- Approximately linear for all 4 pollutants, no apparent threshold
Vulnerable subgroups
- More vulnerable: female sex, age ≥65 years, northern residence, lower educational attainment, no spousal support, cold season
Original publication
Short-Term Exposure to Air Pollution Increases Mortality From Hypertension and its Multiorgan Complications: A Case Crossover Study of 2.1 Million Deaths in China. J Am Coll Cardiol. Published 25 February 2026. doi:10.
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