Date Approved


Graduate Degree Type


Degree Name

Health Sciences (M.H.S.)

Degree Program

Biomedical Sciences

First Advisor

Prof. Francis A. Sylvester

Second Advisor

Prof. John Capodilupo

Third Advisor

Asst. Prof. Ruijie Liu

Academic Year



Cardiovascular disease, which involves a wide range of conditions, including narrowed or blocked coronary arteries, has remained the leading cause of death in the United States for over 50 years. The majority of cardiovascular conditions are preventable, which can be identified through risk factors. However, maintaining healthy life choices can be difficult for most Americans, as the vast majority live in populated urban cities. Urban life can pose hazardous conditions to individuals, especially air pollution. Air pollution includes gaseous pollutants, such as carbon monoxide, nitrogen oxides, ozone and sulfur dioxide, and particulate matter. Of these pollutants, particulate matter has become a significant concern for cardiovascular research. Currently, most studies have focused on individual studies about the association between particulate matter exposure and risk of cardiovascular disease; thus, this study seeks to test multiple studies on particulate matter exposure and risk of cardiovascular disease by developing a different statistical conclusion through a meta-analysis.

A total of 16 case-crossover and time series studies were searched in order to investigate the association between particulate matter exposure (diameter < 2.5 μm [PM2.5] or diameter <10 μm [PM10]) and cardiovascular outcomes. Each study included adults ranging from 45 to 85 years of age, living in U.S. metropolitan areas. A random-effects model was used to derive the overall effect estimates. Statistical analysis was performed using RevMan software version 5.3. Data analysis was prepared by separating and analyzing all 16 studies into three groups by their effect estimate: Hazard Ratio, Risk Ratio, and Odds Ratio (HR, RR, and OR). Forest plots and funnel plots were constructed to determine summary effect estimates and publication biases, respectively. Heterogeneity (I2) and overall effect (z-score) tests demonstrated that there was a significant difference among studies used in all groups (p < 0.05). Using a different approach, this meta-analysis study provided further evidence that particulate matter exposure increases the risk of cardiovascular disease.

Available for download on Monday, January 29, 2024

Included in

Cardiology Commons