Data and code related to “Joint effects of air pollution and compound dry-hot extremes on cardiovascular disease risk across adults: a cohort study in China”

Compound dry-hot extremes (CDHEs) and ambient air pollution are growing public health threats under global climate change, yet their joint impacts on cardiovascular disease (CVD) risk remain poorly understood. Here we conducted a nationwide longitudinal cohort study using the China Family Panel Studies (CFPS) data, including 9,265 Chinese adults (≥18) with 69,297 repeated observations from 2010 to 2018, to evaluate the independent, joint and heterogeneous effects of multi-dimensional CDHE metrics (accumulated days, frequency and average severity) and key air pollutants (e.g., PM2.5) on incident CVD. We found that per interquartile range (IQR) increment in CDHE cumulative days and PM2.5 concentration were associated with 30% (HR=1.30, 95% CI: 1.18-1.43) and 54% (HR=1.54, 95% CI: 1.42-1.67) higher CVD risk, respectively, with CDHE accumulated days rather than event frequency or intensity driving the long-term cardiovascular damage. Both exposures showed the strongest risk elevations for coronary heart disease, with 72% (HR=1.72, 95% CI: 1.51-1.96) and 75% (HR=1.75, 95% CI: 1.54-1.99) risk increments per IQR for CDHE cumulative days and PM2.5, respectively. Critically, concurrent high exposure to CDHEs and PM2.5 induced synergistic elevated CVD risk, with the joint hazard ratio reaching 1.92 (95% CI: 1.71-2.15), and this synergistic pattern was consistent across PM1, PM10, NO2 and O3. Stratified analyses further revealed that older adults, males, urban residents, smokers, drinkers, physically inactive and overweight individuals were more susceptible to these environmental risks. These findings highlight the amplified cardiovascular risks from the interaction of compound climate extremes and air pollution, pointing to the necessity for integrated public health strategies that simultaneously target air quality improvement and climate resilience.