•Nickel and vanadium in PM10 are indices of shipping air pollution.
•Nickel and vanadium were associated with elevated cardiovascular hospitalizations.
•Nickel appeared to correspond better than vanadium to cardiovascular health.
•Controlling residual oil emissions is important in port cities.
Previous studies have suggested nickel (Ni) and vanadium (V) as the likely constituents that are partially responsible for health effects associated with particulate matter pollution. The authors aimed to examine the effects of Ni and V in PM10, the indices of shipping emissions, on emergency hospitalizations for cardiovascular diseases (CVD) in Hong Kong. Daily PM10 speciation data across six monitoring stations in Hong Kong during 1998–2007 were collected. Generalized additive Poisson models with single-day lags were used to estimate the excess risks of emergency hospital admissions for CVD associated with Ni and V, after adjusted for major PM10 chemical species and criteria gaseous pollutants. The excess risks for inter-quartile range (IQR) increases of Ni and V on the same day and previous six days (lag0 ∼ lag6) were estimated. Ni in PM10 was associated with a 1.25% (95%CI: 0.81–1.68%) increase of total emergency CVD admissions on the same day, while lag0 V was associated with a 0.95% (95%CI: 0.55–1.35%) elevated CVD admissions. The associations were not sensitive to the further adjustment for co-pollutants. Ni appeared to correspond better than V to cardiovascular health. Controlling shipping emissions from residual oil combustion in the port cities like Hong Kong is particularly important.