Background: Exposure to fine particulate matter (PM_2.5) air pollution has been associated with cardiovascular disease (CVD). However, coarse particulate matter (PM_10-2.5), particularly long-term exposure, and CVD has less been studied.

Objectives: This study was to examine the association between ambient concentrations of PM_10-2.5 and biomarkers for CVD.

Methods: Annual serum samples and questionnaire data were collected from 1,694 women (mean±SD: 49.4±2.7 years old in 1999) enrolled in the Study of Women's Health Across the Nation (SWAN) from 1999 to 2004 at six study sites throughout the US. One-year exposure to PM_10-2.5, as well as co-pollutants, was assigned based on participants’ residential locations and US EPA ambient air monitoring measurements. Linear mixed-effects regression models were used to characterize the association between PM_10-2.5 exposure and CVD markers, with consideration of age, race/ethnicity, education, menopausal status, body mass index, smoking status, and alcohol consumption.

Results: Each interquartile (4 µg/m³) increase in one-year PM_10-2.5 exposure was associated with a 5.5% (95% CI: 1.8%, 9.4%) increase in levels of plasminogen activator inhibitor-1 (PAI-1), a coagulation marker, and 4.1% (-0.1%, 8.6%) increase in high-sensitivity C-creative Protein (hs-CRP), an inflammatory marker. The association with PAI-1 was particularly elevated among peri-menopausal women and women who were less educated. The association between PM_10-2.5 and PAI-1 remained unchanged after adjusting for PM_2.5, ozone, NO₂ or CO, while the association with hs-CRP was unstable after adjusting for co-pollutants.

Conclusion: Long-term PM_10-2.5 exposure may be associated with changes in coagulation independently from PM_2.5, and thus, contribute to CVD risk in midlife women.