Background. Few studies have investigated associations of aircraft noise with cardiovascular health. We investigated this in areas exposed to noise from London Heathrow airport. Methods. A small area study was conducted in 12,110 census output areas covering 3.6 million residents. Risks for hospital admissions and mortality in 2001-05 were assessed in relation to aircraft noise in 2001, adjusted for relevant confounders. Night (Lnight) and daytime (LAeq,16h) aircraft noise were assessed separately. Results. Higher aircraft noise was associated with higher relative risks for hospital admissions and mortality from stroke, coronary heart disease (CHD) and cardiovascular disease. Risk estimates were higher for night-time than daytime noise. Adjusted risks werehighest for stroke, with RR 1.29 [95% CI 1.14 to 1.46] for Lnight and RR 1.08 [95% CI 1.02 to 1.14] for LAeq,16hfor >55dB vs. <50dB. All linear dose-response relationships were statistically significant for hospital admissions but not for mortality, except for CHD and LAeq,16h. Discussion. This research attracted a high level of policy interest. However, the impact of this and other recent papers on policy decisions such as increased airport capacity in England is currently unclear. Priority areas for follow-up health research into aircraft noise need to be considered.