Associations between long-term air pollution exposure and the incidence of cardiovascular diseases among American older adults

•A nationwide Medicare cohort study was conducted across the contiguous U.S.•Associations were examined using co-pollutant models and at low pollution levels.•Potential effect modifications by race/ethnicity and comorbidities were assessed.•Air pollution is found associated with incidence of CVD even at low concentration.•People who identify as Black or have diabetes are more susceptible to air pollution.