Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 25:S0735-1097(25)06967-0.
doi: 10.1016/j.jacc.2025.06.037. Online ahead of print.

Effect of HEPA Filtration Air Purifiers on Blood Pressure: A Pragmatic Randomized Crossover Trial

Doug Brugge  1 , Misha Eliasziw  2 , Mohan Thanikachalam  2 , Vedaant Kuchhal  3 , Chermaine Morson  4 , Teresa Vazquez-Dodero  4 , Amy Mertl  5 , Pratham Tallam  6 , Sangita Kunwar  4 , Linda Sprague Martinez  7 , Humza Shamoon Rashid  4 , Kiran Singh-Smith  4 , Hunter Gates  4 , Sharly Palma  6 , Warren Goldstein-Gelb  8 , Shir Lerman Ginzburg  9 , Scott Oakley Hersey  3 , Francesca Majluf  3 , Wig Zamore  10
Affiliations
Free article

Effect of HEPA Filtration Air Purifiers on Blood Pressure: A Pragmatic Randomized Crossover Trial

Doug Brugge et al. J Am Coll Cardiol. .
Free article

Abstract

Background: Particulate matter (PM) pollution is a leading cause of cardiovascular risk and illness, including elevated blood pressure (BP).

Objectives: The purpose of this study was to test the efficacy of in-home air purifiers to reduce BP for adults living adjacent to highways.

Methods: We conducted a pragmatic randomized crossover trial of the effect of high-efficiency particulate arrestance (HEPA) vs sham filtration on BP. Residences were randomized to start with 1 month of HEPA filtration or 1 month of sham filtration. A 1-month wash out period with no filtration was followed by 1 month of the alternate filtration. Participant questionnaire data and BP were collected 4 times, at the start and end of each filtration period. PM concentrations were measured in a subset of residences. Linear mixed models were used to compare the mean change in BP between the HEPA and sham filtration periods. Models were adjusted for time invariant and time-varying covariates.

Results: A total of 154 participants were analyzed. The mean age was 41.1 years, 59.7% were women, 68.2% were non-Hispanic White, and a majority were of higher socioeconomic status. The mean baseline brachial systolic blood pressure (SBP)/diastolic BP was 118.8/76.5 mm Hg. HEPA filtration significantly reduced PM in comparison to both indoor sham and outdoor levels. Participants' SBP at the start of the intervention period moderated the efficacy of the intervention (P = 0.03). Participants who had elevated brachial SBP (≥120 mm Hg) had a significant 2.8-mm Hg mean reduction in SBP after HEPA filtration (P = 0.03) and a 0.2-mm Hg mean increase in SBP after sham filtration (P = 0.85). The net result was a significant 3.0-mm Hg mean difference in favor of HEPA filtration (P = 0.04). There was no significant benefit on diastolic BP or for participants with normal SBP (<120 mm Hg).

Conclusions: The use of in-home HEPA air purifiers resulted in clinically important reductions in SBP for people with elevated SBP in environments with relatively low PM2.5 concentrations.

Keywords: HEPA air filtration; air purifiers; blood pressure; highway traffic; particulate matter pollution; randomized crossover trial.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures This study was supported by the National Institute of Environmental Health Sciences Grant ID: R01 ES030289 and the School of Medicine at the University of Connecticut. The air purifiers were custom adapted by the manufacturer, Austin Air, and sold at a discount based on bulk purchase. The manufacturer was not involved in any way in the design, conduct or analysis. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Similar articles

See all similar articles

LinkOut - more resources