BACKGROUND: The risk for cardiovascular events increases within hours of near-roadway exposures. We aimed to determine the traffic-related air pollutants (TRAP) and biological mechanisms involved and if reducing particulate matter<2.5 microm (PM2.5) inhalation is protective. METHODS: Fifty healthy-adults underwent multiple 2-hour near-roadway exposures (Tuesdays-Fridays) in Ann Arbor during 2 separate weeks (randomized to wear an N95-respirator during one week). Monday both weeks, participants rested 2-hours in an exam room (once wearing an N95-respirator). Brachial blood pressure, aortic hemodynamics and heart rate variability were repeatedly-measured during exposures. Endothelial function (reactive hyperemia index [RHI]) was measured post-exposures (Thursdays). Black carbon (BC), total particle count (PC), PM2.5, noise and temperature were measured throughout exposures. RESULTS: PM2.5 (9.3+/-7.7 microg/m3), BC (1.3+/-0.6 microg/m3), PC (8375+/-4930 particles/cm3) and noise (69.2+/-4.2 dB) were higher (p-values<0.01) and aortic hemodynamic parameters trended worse while near-roadway (p-values<0.15 versus exam room). Other outcomes were unchanged. Aortic hemodynamics trended towards improvements with N95-respirator usage while near-roadway (p-values<0.15 versus no-use), whereas other outcomes remained unaffected. Higher near-roadway PC and BC exposures were associated with increases in aortic augmentation pressures (p-values<0.05) and trends toward lower RHI (p-values<0.2). N95-respirator usage did not mitigate these adverse responses (non-significant pollutant-respirator interactions). Near-roadway outdoor-temperature and noise were also associated with cardiovascular changes. CONCLUSIONS: Exposure to real-world combustion-derived particulates in TRAP, even at relatively-low concentrations, acutely worsened aortic hemodynamics. Our mixed findings regarding the health benefits of wearing N95-respirators support that further studies are needed to validate if they adequately-protect against TRAP given their growing worldwide usage.