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. 2020 Mar:182:109109.
doi: 10.1016/j.envres.2019.109109. Epub 2020 Jan 7.

Associations between long-term exposure to air pollution and blood pressure and effect modifications by behavioral factors

Na Li  1 , Gongbo Chen  1 , Feifei Liu  1 , Shuyuan Mao  1 , Yisi Liu  2 , Suyang Liu  1 , Zongfu Mao  1 , Yuanan Lu  3 , Chongjian Wang  4 , Yuming Guo  5 , Hao Xiang  6 , Shanshan Li  7
Affiliations

Associations between long-term exposure to air pollution and blood pressure and effect modifications by behavioral factors

Na Li et al. Environ Res. 2020 Mar.

Abstract

Background: Studies on the hypertensive effect of long-term air pollution exposure were inconclusive and showed scarce evidence from rural areas in developing countries. In this context, we examined the associations of air pollution exposure with hypertension and blood pressure, and their effect modifiers in rural Chinese adults.

Methods: We studied 39,259 participants from a cohort established in five rural regions of central China. Individual exposures to PM2.5 and PM10 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm and 10 μm) and nitrogen dioxide (NO2) was evaluated using satellite-based spatiotemporal models. Mixed-effect regression models were applied to examine the associations of long-term exposure to air pollution with hypertension and four blood pressure component measurements, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Several potential effect modifiers related to demographic and behavioral factors were also examined.

Results: The results showed that for each 1 μg/m3 increase in PM2.5, PM10 and NO2, the adjusted odds ratio of hypertension was 1.029 (95%CI: 1.001,1.057), 1.015 (95%CI: 1.001, 1.029) and 1.069 (95%CI: 1.038, 1.100), respectively. These three air pollutants were also associated with increased SBP (except for PM10), DBP and MAP. The hypertensive effects of air pollution were more pronounced among males, smokers, drinkers, individuals with a high-fat diet, and those with high-level physical activity.

Conclusion: Long-term exposure to PM2.5, PM10 and NO2 was associated with increased blood pressure and hypertension in rural Chinese adults, and the associations were modified by several behavioral factors.

Keywords: Air pollution; Blood pressure; Effect modification; Hypertension; Rural China.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Associations between 1 μg/m3 increase in air pollutants and odds ratio (95%CIs) of hypertension, stratified by potential modifiers. Abbreviations: HF diet, high fat diet; More veg: More vegetables and fruits intake; Phy: levels of physical activity. *P for interaction <0.05.
Fig. 2
Fig. 2
Associations between 1 μg/m3 increase in air pollutants and changes (95% CIs) in blood pressure measurements, stratified by potential modifiers. Abbreviations: HF diet, high fat diet; More veg: More vegetables and fruits intake; Phy: levels of physical activity. *P for interaction <0.05.
See this image and copyright information in PMC

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