Long-term effects of ambient PM2.5 on hypertension in multi-ethnic population from Sichuan province, China: a study based on 2013 and 2018 health service surveys

Blood Lead Mediates the Relationship between Biological Aging and Hypertension: Based on the NHANES Database

Hypertension remains a major global public health crisis due to various contributing factors, such as age and environmental exposures. This study delves into exploring the intricate association between biological aging, blood lead levels, and hypertension, along with examining the mediating role of blood lead levels in the relationship between biological aging and hypertension. We analyzed data from two cycles of the NHANES, encompassing 4473 individuals aged 18 years and older. Our findings indicate that biological aging potentially escalates the risk of hypertension and the incidences of systolic blood pressure (SBP) and diastolic blood pressure (DBP) abnormalities. Utilizing weighted quantile sum (WQS) and quantile g-computation (QGC) model analyses, we observed that exposure to heavy metal mixtures, particularly lead, may elevate the likelihood of hypertension, SBP, and DBP abnormalities. Further mediation analysis revealed that lead significantly mediated the relationship between biological aging and hypertension and between biological aging and SBP abnormalities, accounting for 64% (95% CI, 49% to 89%) and 64% (95% CI, 44% to 88%) of the effects, respectively. These outcomes emphasize the criticality of implementing environmental health measures.

Associations between long-term exposure to air pollution, diabetes, and hypertension in metropolitan Iran: an ecologic study

Epidemiological studies on air pollution, diabetes, and hypertension conflict. This study examined air pollution, diabetes, and hypertension in adults in 11 metropolitan areas of Iran (2012-2016). Local environment departments and the Tehran Air Quality Control Company provided air quality data. The VIZIT website and Stepwise Approach to Chronic Disease Risk Factor Surveillance study delivered chronic disease data. Multiple logistic regression and generalized estimating equations evaluated air pollution-related diabetes and hypertension. In Isfahan, Ahvaz, and Tehran, PM2.5 was linked to diabetes. In all cities except Urmia, Yasuj, and Yazd, PM2.5 was statistically related to hypertension. O3 was connected to hypertension in Ahvaz, Tehran, and Shiraz, whereas NO2 was not. BMI and gender predict hypertension and diabetes. Diabetes, SBP, and total cholesterol were correlated. Iran's largest cities' poor air quality may promote diabetes and hypertension. PM2.5 impacts many cities' outcomes. Therefore, politicians and specialists have to control air pollution.

Burden of cardiovascular disease attributed to air pollution: a systematic review

BACKGROUND

Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics.

METHODS

A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle-Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study.

RESULTS

Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016-2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014.

CONCLUSION

Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.

Diversity and negative effect of PM0.3-10.0 adsorbed by needles of urban trees in Irkutsk, Russia

The study was performed in natural forests preserved within the Boreal zone city, Irkutsk, Russia. Test sites were selected in the forests in different districts of the city, where samples of Scots pine (Pinus sylvestris L.) and Siberian larch (Larix sibirica Ledeb.) needles were taken to study the adsorption on their surface of aerosol particles of different sizes, in microns: PM0.3, PM0.5, PM1, PM2.5, PM5, PM10. Scanning electron microscopy was used to obtain high-resolution photographs (magnification 800- × 2000, × 16,000) and aerosol particles (particulate matter-PM) were shown to be intensively adsorbed by the surface of needles, with both size and shape of the particles characterized by a wide variety. Pine needles can be covered with particles of solid aerosol by 50-75%, stomata are often completely blocked. Larch needles often show areas, which are completely covered with aerosol particles, there are often found stomata deformed by the penetration of PMx. X-ray spectral microanalysis showed differences in the chemical composition of adsorbed PMx, the particles can be metallic if metals predominate in their composition, carbonaceous-in case of carbon predominance-or polyelemental if the composition is complex and includes significant quantities of other elements besides metals and carbon (calcium, magnesium, potassium, sodium, sulfur, chlorine, fluorine). Since the particles contain a large proportion of technogenic pollutants, accumulation by the needles of some widespread pollutants was investigated. A direct correlation of a highly significant level between the concentration of PMx in the air and the accumulation of many heavy metals in pine and larch needles, as well as sulfur, fluorine, and chlorine, has been revealed, which indicates a high cleaning capacity of urban forests. At the same time, the negative impact of PMx particles on the vital status of trees is great, which shows in intense disturbance of the parameters of photosynthesis and transpiration, leading to a significant decrease in the growth characteristics of trees and reduction in the photosynthetic volume of the crowns. We consider that the results obtained are instrumental in developing an approach to improvement of urban forests status and creating a comfortable urban environment for the population.

Mediating effect of body fat percentage in the association between ambient particulate matter exposure and hypertension: a subset analysis of China hypertension survey

BACKGROUND

Hypertension caused by air pollution exposure is a growing concern in China. The association between air pollutant exposure and hypertension has been found to be potentiated by obesity, however, little is known about the processes mediating this association. This study investigated the association between fine particulate matter (aerodynamic equivalent diameter ≤ 2.5 microns, PM2.5) exposure and the prevalence of hypertension in a representative population in southern China and tested whether obesity mediated this association.

METHODS

A total of 14,308 adults from 48 communities/villages in southern China were selected from January 2015 to December 2015 using a stratified multistage random sampling method. Hourly PM2.5 measurements were collected from the China National Environmental Monitoring Centre. Restricted cubic splines were used to analyze the nonlinear dose-response relationship between PM2.5 exposure and hypertension risk. The mediating effect mechanism of obesity on PM2.5-associated hypertension was tested in a causal inference framework following the approach proposed by Imai and Keele.

RESULTS

A total of 20.7% (2966/14,308) of participants in the present study were diagnosed with hypertension. Nonlinear exposure-response analysis revealed that exposure to an annual mean PM2.5 concentration above 41.8 µg/m3 was associated with increased hypertension risk at an incremental gradient. 9.1% of the hypertension burden could be attributed to exposure to elevated annual average concentrations of PM2.5. It is noteworthy that an increased body fat percentage positively mediated 59.3% of the association between PM2.5 exposure and hypertension risk, whereas body mass index mediated 34.3% of this association.

CONCLUSIONS

This study suggests that a significant portion of the estimated effect of exposure to PM2.5 on the risk of hypertension appears to be attributed to its effect on alterations in body composition and the development of obesity. These findings could inform intersectoral actions in future studies to protect populations with excessive fine particle exposure from developing hypertension.

Overview of PM2.5 and health outcomes: Focusing on components, sources, and pollutant mixture co-exposure

PM_2.5 varies in source and composition over time and space as a complicated mixture. Consequently, the health effects caused by PM_2.5 varies significantly over time and generally exhibit significant regional variations. According to numerous studies, a notable relationship exists between PM_2.5 and the occurrence of many diseases, such as respiratory, cardiovascular, and nervous system diseases, as well as cancer. Therefore, a comprehensive understanding of the effect of PM_2.5 on human health is critical. The toxic effects of various PM_2.5 components, as well as the overall toxicity of PM_2.5 are discussed in this review to provide a foundation for precise PM_2.5 emission control. Furthermore, this review summarizes the synergistic effect of PM_2.5 and other pollutants, which can be used to draft effective policies.

Long-term effects of PM2.5 components on hypertension: A national analysis in China

BACKGROUND

Evidence is less about the associations between fine particulate matter (PM_2.5) components and hypertension. We aimed to examine the long-term effects of PM_2.5 components on prevalence of hypertension, diastolic blood pressure (DBP) and systolic blood pressure (SBP).

METHODS

We included participants between March 1, and July 31, 2021, from 13 provinces in China. Geocoded residential address was used for exposure assignment. Mixed-effect regression was used to assess 3-year average concentrations of PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) on prevalence of hypertension, DBP and SBP with covariate-adjusted. SHapley Additive exPlanation was used to compare the contribution of PM_2.5 components to hypertension, DBP, and SBP. Sex and age subgroup were also analyzed.

RESULTS

We enrolled a total of 113,159 participants aged ≥18 years. Long-term exposure to PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) had associations with prevalence of hypertension, with the Odds Ratios and 95% confidence interval (CI) of 1.06 (95%CI: 1.03-1.09), 1.07 (95%CI: 1.04-1.09), 1.07 (95%CI: 1.04-1.10), 1.05 (95%CI: 1.01-1.08), 1.03 (95%CI: 1.00-1.06), and 1.03 (95%CI: 1.00-1.04), respectively. Effects of that except for black carbon on DBP with per interquartile upticks of concentration were 0.23 (95%CI: 0.11-0.35), 0.17 (95%CI: 0.04-0.29), 0.35 (95%CI: 0.21-0.48), 0.40 (95%CI: 0.28-0.52), and 0.25 (95%CI: 0.13-0.26), respectively. Ammonium was associated with SBP, corresponding to an increase of 0.18 (95%CI: 0.01-0.35). Males had higher risks of DBP (Z = 2.54-6.08, P < 0.001). Older people were substantially more affected by PM_2.5 and its components. Nitrate showed the highest contribution to hypertension, DBP and SBP compared with other components.

CONCLUSIONS

Long-term exposure to PM_2.5 and its components had adverse consequences on prevalence of hypertension, DBP and SBP, especially for males and older people. Nitrate contributed the highest to hypertension, DBP and SBP. Findings may have implications for pollution and hypertension control.

Association between long-term exposure to ambient particulate matter and blood pressure, hypertension: an updated systematic review and meta-analysis

Evidence of more recent studies should be updated to evaluate the effect of long-term exposure to particulate matter (PM) on blood pressure and hypertension.        Studies of long-term effects of PM₁, PM_2.5 and PM₁₀ on blood pressure (SBP, DBP, MAP), hypertension were searched in Pubmed, Web of Science and Embase before May, 2021. Meta-analysis of 41 studies showed that exposure to PM₁, PM_2.5 was associated with SBP (1.76 mmHg (95%CI:0.71, 2.80) and 0.63 mmHg (95%CI:0.40, 0.85), per 10 μg/m³ increase in PM), all three air pollutants (PM₁, PM_2.5, PM₁₀) was associated with DBP (1.16 mmHg (95%CI:0.34, 1.99), 0.31 mmHg (95%CI:0.16, 0.47), 1.17 mmHg (95%CI:0.24, 2.09), respectively. As for hypertension, PM₁, PM_2.5 and PM₁₀ were all significantly associated with higher risk of hypertension (OR=1.27 (95%CI:1.06, 1.52), 1.15 (95%CI:1.10, 1.20) and 1.11 (95%CI:1.07, 1.16). In conclusion, our study indicated a positive association between long-term exposure to particulate matter and increased blood pressure, hypertension.

Polycyclic aromatic hydrocarbons in urban particle matter exacerbate movement disorder after ischemic stroke via potentiation of neuroinflammation

BACKGROUND

A recent epidemiological study showed that air pollution is closely involved in the prognosis of ischemic stroke. We and others have reported that microglial activation in ischemic stroke plays an important role in neuronal damage. In this study, we investigated the effects of urban aerosol exposure on neuroinflammation and the prognosis of ischemic stroke using a mouse photothrombotic model.

RESULTS

When mice were intranasally exposed to CRM28, urban aerosols collected in Beijing, China, for 7 days, microglial activation was observed in the olfactory bulb and cerebral cortex. Mice exposed to CRM28 showed increased microglial activity and exacerbation of movement disorder after ischemic stroke induction. Administration of core particles stripped of attached chemicals from CRM28 by washing showed less microglial activation and suppression of movement disorder compared with CRM28-treated groups. CRM28 exposure did not affect the prognosis of ischemic stroke in null mice for aryl hydrocarbon receptor, a polycyclic aromatic hydrocarbon (PAH) receptor. Exposure to PM2.5 collected at Yokohama, Japan also exacerbated movement disorder after ischemic stroke.

CONCLUSION

Particle matter in the air is involved in neuroinflammation and aggravation of the prognosis of ischemic stroke; furthermore, PAHs in the particle matter could be responsible for the prognosis exacerbation.

Long-term exposure to PM2.5 and PM10 and chronic kidney disease: the Beijing Health Management Cohort, from 2013 to 2018

Long-term exposure to ambient particulate pollutants (PM_2.5 and PM₁₀) may increase the risk of chronic kidney disease (CKD), but the results of previous research were limited and inconsistent. The purpose of this study was to assess the relationships of PM_2.5 and PM₁₀ with CKD. This study was a cohort study based on the physical examination data of 2082 Beijing residents from 2013 to 2018 in the Beijing Health Management Cohort (BHMC). A land-use regression model was used to estimate the individual exposure concentration of air pollution based on the address provided by each participant. CKD events were identified based on self-report or medical evaluation (estimated glomerular filtration rate, eGFR less than 60 ml/min/1.73 m²). Finally, the associations of PM_2.5 and PM₁₀ with CKD were calculated using univariate and multivariate logistic regression models. During the research period, we collected potentially confounding information. After adjusting for confounders, each 10 μg/m³ increase in PM_2.5 and PM₁₀ exposure was associated with an 84% (OR: 1.84; 95% CI: 1.45, 2.33) and 37% (OR: 1.37; 95% CI: 1.15, 1.63) increased risk of CKD. Adjusting for the four common gaseous air pollutants (CO, NO₂, SO₂, O₃), the effect of PM_2.5 and PM₁₀ on CKD was significantly enhanced, but the effect of PM₁₀ was no longer significant in the multi-pollutant model. The results of the stratified analysis showed that PM_2.5 and PM₁₀ were more significant in males, middle-aged and elderly people over 45 years old, smokers, drinkers, BMI ≥ 24 kg/m², and abnormal metabolic components. In conclusion, long-term exposure to ambient PM_2.5 and PM₁₀ was associated with an increased risk of CKD.

Surveillance of long-term environmental elements and PM2.5 health risk assessment in Yangtze River Delta, China, from 2016 to 2020

PM2.5 metal pollution significantly harms human health. The air quality in Wuxi is poor, especially in winter, and long-term monitoring of PM2.5 elements comprising has not been performed previously. In the present study, 420 PM2.5 samples were collected from January 2016 to December 2020. Eleven elements, including Al, Mn, Ni, Cr, As, Cd, Sb, Hg, Pb, Se, and Tl, were analyzed by inductively coupled plasma mass spectrometry. The mean PM2.5 level was 56.1 ± 31.0 μg/m3, with a tendency of yearly decreasing and a significant seasonal distribution variation. The concentration of 11 elements in the PM2.5 samples was 0.38 ± 0.33 μg/m3. Al was the highest element with a range of 37.5-2148 ng/m3. Meanwhile, the spatial distribution differences were compared by literatures review. Based on the Crystal Ball model, health risks were assessed dynamically using Monte Carlo uncertainty analysis. After 10,000 simulations, the mean value of the hazard index for nine elements was 0.743, and Mn contributed the most to the hazard index among elements, with a correlation of 0.3464. The average carcinogenic risk was 1.01 × 10-5, which indicated that the non-carcinogenic and carcinogenic risks were within the acceptable range. However, considerable attention should be paid to the potential health risks associated with long-term Al, Mn, and As exposure. This study provides detailed data on local atmospheric pollution characteristics, helps identify potential risk elements, and contributes to the development of effective regional air quality management.

Prenatal Exposure to PM2.5 and Its Specific Components and Risk of Hypertensive Disorders in Pregnancy: A Nationwide Cohort Study in China

Hypertensive disorders in pregnancy (HDP) are a leading cause of maternal mortality and adverse birth outcomes. Fine particulate matter (PM_2.5) has been linked to HDP risk; however, limited studies have explored the relationships between specific chemical constituents of PM_2.5 and HDP risk. Based on maternal data from the China Labor and Delivery Survey (CLDS), this study included a total of 67,659 participants from 95 participant hospitals in 25 provinces of China between March 1, 2015, and December 31, 2016. Maternal exposure to total PM_2.5 mass and six main components during pregestation and pregnancy were estimated using the Combined Geoscience-Statistical Method. Multilevel logistic regression models were applied to quantify the associations, controlling for sociodemographic characteristics. We found that an interquartile range (IQR) increase in PM_2.5 exposure during the second trimester was associated with a 14% increase in HDP risk (95% CI: 2%, 29%). We observed that black carbon (BC) and SO₄^2- had larger or comparable estimates of the effect than total PM_2.5 mass. The association estimates were greater in the gestational hypertension group than in the group of pre-eclampsia and eclampsia. Our findings suggest that PM_2.5 exposure and specific chemical components (particularly BC and SO₄^2-) were associated with an increased HDP risk in China.

The Impact of PM2.5 on the Growth Curves of Children's Obesity Indexes: A Prospective Cohort Study

Aims

To explore the effect of long-term exposure to particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) on childhood obesity based on a cohort study in Chongqing.

Methods

A total of 4,284 children aged 6-8 years at baseline were enrolled from the Chongqing Children Health Cohort in 2014-2015 and were followed up in 2019. A stratified cluster sampling was applied to select the participants. A Mixed-effects linear regression model was used to examine the effect of long-term exposure to PM2.5 on the growth curve of obesity indicators [including body mass index (BMI), BMI Z-score (BMIz), and waist-to-height ratio (WHtR)]. A mixed-effects logistic regression model was used to study the dose relationship between PM2.5 exposure and the risk of obesity indicators.

Results

A higher level of accumulating exposure to PM2.5 was associated with an increased childhood obesity index, and the effect was the most significant for WHtR than BMI and BMIz. This effect was more pronounced in boys than in girls except for WHtR, and it was the most significant under the PM2.5 exposure period from pregnancy to 6 years old. Compared the annual average PM2.5 exposure level of <60 μg/m³, the WHtR and BMI were increased by 0.019 [(95% CIs): 0.014, 0.024] and 0.326 [(95% CIs): 0.037, 0.616] Kg/m² for participants living with the PM2.5 exposure level of 70-75 μg/m³, respectively. For every 5 μg/m³ increase in PM2.5 levels (from pregnancy to 6 years old), the risk of central obesity was increased by 1.26 {odds ratio [OR] (95% CIs): 1.26 (1.16, 1.37), p < 0.001} times.

Conclusions

This study confirmed a dose-response relationship between PM2.5 exposure and childhood obesity, especially central obesity, suggesting that controlling ambient air pollution can prevent the occurrence of obesity in children and adolescents.

Association between long-term exposure to PM2.5 and hypertension: A systematic review and meta-analysis of observational studies

BACKGROUND

Numerous studies have examined the association between long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM_2.5) and hypertension. However, the results are inconsistent.

OBJECTIVES

Considering the limitations of previous meta-analyses and the publication of many new studies in recent years, we conducted this meta-analysis to assess the relationship between long-term PM_2.5 exposure and the incidence and prevalence of hypertension in a healthy population.

METHODS

We searched PubMed, Web of Science, Embase, and Scopus for relevant studies published until April 2, 2021 and reviewed the reference lists of previous reviews. A total of 28 observational studies reporting RR or OR with 95% CI for the association between long-term PM_2.5 exposure and the risk of hypertension were included.

RESULTS

After the sensitivity analysis, we excluded one study with a high degree of heterogeneity, resulting in 27 studies and 28 independent reports. Approximately 42 million participants were involved, and the cases of hypertension in cohort and cross-sectional studies were 508,749 and 1,793,003, respectively. The meta-analysis showed that each 10 μg/m³ increment in PM_2.5 was significantly associated with the risks of hypertension incidence (RR = 1.21, 95% CI: 1.07, 1.35) and prevalence (OR = 1.06, 95% CI: 1.03, 1.09). Subgroup analyses showed that occupational exposure had a significant effect on the association of PM_2.5 and hypertension incidence (p for interaction = 0.042) and that the PM_2.5 concentration level and physical activity had a noticeable effect on the association of PM_2.5 and hypertension prevalence (p for interaction = 0.005; p for interaction = 0.022).

CONCLUSIONS

A significantly positive correlation was observed between long-term PM_2.5 exposure and risks of hypertension incidence and prevalence, and a high PM_2.5 concentration resulted in an increased risk of hypertension.

Association between Particulate Matter Pollution Concentration and Hospital Admissions for Hypertension in Ganzhou, China

Fine particulate matter (PM_2.5) and respirable particulate matter (PM₁₀) are two major air pollutants with toxic effects on the cardiovascular system. Hypertension, as a chronic noncommunicable cardiovascular disease, is also a risk factor for several diseases. We applied generalized linear models with a quasi-Poisson link to assess the effect of air pollution exposure on the number of daily admissions for patients with hypertension. In addition, we established a two-pollutant model to evaluate PM_2.5 and PM₁₀ hazard effect stability by adjusting the other gaseous pollutants. Results showed that during the study period, 24 h mean concentrations of ambient PM_2.5 and PM₁₀ at 38.17 and 59.84 μg/m³, respectively, and a total of 2,611 hypertension hospital admissions were recorded. Air pollution concentrations significantly affected the number of hospitalizations for hypertension approximately 2 months after exposure. For each 10 μg/m³ increase in PM_2.5 and PM₁₀ in single-pollutant models, the number of hospitalizations for hypertension increased by 7.92% (95% CI: 5.48% to 10.42%) and 4.46% (95% CI: 2.86% to 5.65%), respectively, at the lag day with the strongest effect. NO₂, O₃, CO, and SO₂ had different significant effects on the number of hospitalizations over the same time period, and PM_2.5 and PM₁₀ still showed robust significant effects after adjustment of gas pollutants through a two-pollutant model. These findings may contribute to a better understanding of the health effects of ambient particulate matter.

Associations of long-term exposure to air pollution with blood pressure and homocysteine among adults in Beijing, China: A cross-sectional study

BACKGROUND

Studies on the hypertensive effect of long-term exposure to air pollution are mixed, and sparse evidence exists regarding its effects on homocysteine (Hcy), another crucial risk factor for cardiovascular disease (CVD).

METHODS

We collected data from 23,256 participants aged 18-74 years at baseline (years 2017-2018) from a community-based cohort in China. A linear combination of concentrations from monitoring stations at the participants' home and work addresses, weighted by the time, was used to estimate two-year exposures to particulate matter with fine particles≤2.5 μm (PM_2.5), aerodynamic diameter≤10 μm (PM₁₀), nitrogen dioxide (NO₂) and sulfur dioxide (SO₂). Generalized linear regressions and logistic regressions were conducted to examine the associations between air pollution and systolic blood pressure (SBP), diastolic blood pressure (DBP), Hcy, hypertension and co-occurrence of hypertension and hyperhomocysteinemia (HHcy).

RESULTS

The results showed that each interquartile range (IQR) increase in PM_2.5 (16.1 μg/m³), PM₁₀ (19.3 μg/m³) and SO₂ (3.9 μg/m³) was significantly associated with SBP (changes: 0.64-1.86 mmHg), DBP (changes: 0.35-0.70 mmHg) and Hcy (changes: 0.77-1.04 μmol/L) in the fully adjusted model. These air pollutants were also statistically associated with the prevalence of co-occurrence of hypertension and HHcy (ORs: 1.22-1.32), which were stronger than associations with the prevalence of hypertension (ORs: 1.09-1.19). The hypertensive effects of exposure to PM_2.5, PM₁₀ and SO₂ were more pronounced among elder participants, obese participants, those with established CVD or a high 10-year CVD risk and those with a family history of hypertension. However, interaction analyses of Hcy showed different patterns. Additionally, moderate level of physical activity and active travel mode benefited individuals in resisting the health impacts of air pollution on both blood pressure (BP) and Hcy.

CONCLUSIONS

Our study supports a positive relationship between air pollution and BP and Hcy among adults in Beijing, and close attention to vulnerable populations and healthy lifestyles could effectively benefit further cardiovascular health.