Study Protocol for the AIRCARD Study: A Prospective Cohort Study Utilizing DANCAVAS and VIVA Screening Trials: AIRCARD

Background: The AIRCARD study is designed to investigate the relationship between long-term exposure to air and noise pollution and cardiovascular disease incidence and mortality. Aim: To conduct a robust prospective cohort analysis assessing the cumulative and differential impacts of air and noise pollution exposure on cardiovascular disease and mortality. This study will adjust for relevant confounders, including traditional cardiovascular risk factors, socioeconomic indicators, and medication use. Methods: This prospective cohort study will include male participants aged 65-74, recruited from the two large Danish DANCAVAS and VIVA trials, both population-based randomized, multicentered, clinically controlled studies. We will assess long-term exposure to air pollutants using the state-of-the-art DEHM/UBM/AirGIS modelling system and noise pollution through the Nord2000 and SoundPLAN models, covering data from 1979 to 2019. The primary analysis will utilize Cox proportional hazards models, adjusted for confounders identified in the cohort (age, body mass index, hypertension, diabetes, smoking status, family history of heart disease, socioeconomic factors, and medication use). Discussion: The AIRCARD study will address global concerns about the impact of air and noise pollution on cardiovascular disease. This research is crucial for understanding how the pollutants contribute to cardiovascular disease. We aim to provide valuable insights into this area, emphasizing the need for public health measures to mitigate pollution exposure. Our goal is to provide policymakers and healthcare professionals with information on the role of environmental factors in cardiovascular health that could influence global strategies to reduce the cardiovascular disease burden associated with pollution.