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Abulikemu A, Zhang X, Su X, Meng T, Su W, Shi Q, Yu T, Niu Y, Yu H, Yuan H, Zhou C, Yang H, Zhang Y, Wang Y, Dai Y, Duan H. Particulate matter, polycyclic aromatic hydrocarbons and metals, platelet parameters and blood pressure alteration: Multi-pollutants study among population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 941:173657. [PMID: 38838997 DOI: 10.1016/j.scitotenv.2024.173657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
Epidemiological findings have determined the linkage of fine particulate matter (PM2.5) and the morbidity of hypertension. However, the mode of action and specific contribution of PM2.5 component in the blood pressure elevation remain unclear. Platelets are critical for vascular homeostasis and thrombosis, which may be involved in the increase of blood pressure. Among 240 high-PM2.5 exposed, 318 low-PM2.5 exposed workers in a coking plant and 210 workers in the oxygen plant and cold-rolling mill enrolled in present study, both internal and external exposure characteristics were obtained, and we performed linear regression, adaptive elastic net regression, quantile g-computation and mediation analyses to analyze the relationship between urine metabolites of polycyclic aromatic hydrocarbons (PAHs) and metals fractions with platelets indices and blood pressure indicators. We found that PM2.5 exposure leads to increased systolic blood pressure (SBP) and pulse pressure (PP). Specifically, for every 10 μg/m3 increase in PM2.5, there was a 0.09 mmHg rise in PP. Additionally, one IQR increase in urinary 1-hydroxypyrene (1.06 μmol/mol creatinine) was associated with a 3.43 % elevation in PP. Similarly, an IQR increment of urine cobalt (2.31 μmol/mol creatinine) was associated with a separate 1.77 % and 4.71 % elevation of SBP and PP. Notably, platelet-to-lymphocyte ratio (PLR) played a mediating role in the elevation of SBP and PP induced by cobalt. Our multi-pollutants results showed that PAHs and cobalt were deleterious contributors to the elevated blood pressure. These findings deepen our understanding of the cardiovascular effects associated with PM2.5 constituents, highlighting the importance of increased vigilance in monitoring and controlling the harmful components in PM2.5.
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Affiliation(s)
- Alimire Abulikemu
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xuewei Zhang
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xizi Su
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Meng
- Institute of Brain Science, Shanxi Datong University, Datong, China
| | - Wenge Su
- Laigang Hospital Affiliated to Taishan Medical University, Jinan, China
| | - Qiwei Shi
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Tao Yu
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong Niu
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haitao Yu
- Laigang Hospital Affiliated to Taishan Medical University, Jinan, China
| | - Huige Yuan
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cailan Zhou
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haoying Yang
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanshu Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yanhua Wang
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yufei Dai
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huawei Duan
- State Key Laboratory of Trauma and Chemical Poisoning, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
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Chen Z, Huo X, Huang Y, Cheng Z, Xu X, Li Z. Elevated plasma solMER concentrations link ambient PM 2.5 and PAHs to myocardial injury and reduced left ventricular systolic function in children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 355:124151. [PMID: 38740242 DOI: 10.1016/j.envpol.2024.124151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024]
Abstract
Exposure to fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) is known to be associated with the polarization of pro-inflammatory macrophages and the development of various cardiovascular diseases. The pro-inflammatory polarization of resident cardiac macrophages (cMacs) enhances the cleavage of membrane-bound myeloid-epithelial-reproductive receptor tyrosine kinase (MerTK) and promotes the formation of soluble MerTK (solMER). This process influences the involvement of cMacs in cardiac repair, thus leading to an imbalance in cardiac homeostasis, myocardial injury, and reduced cardiac function. However, the relative impacts of PM2.5 and PAHs on human cMacs have yet to be elucidated. In this study, we aimed to investigate the effects of PM2.5 and PAH exposure on solMER in terms of myocardial injury and left ventricular (LV) systolic function in healthy children. A total of 258 children (aged three to six years) were recruited from Guiyu (an area exposed to e-waste) and Haojiang (a reference area). Mean daily PM2.5 concentration data were collected to calculate the individual chronic daily intake (CDI) of PM2.5. We determined concentrations of solMER and creatine kinase MB (CKMB) in plasma, and hydroxylated PAHs (OH-PAHs) in urine. LV systolic function was evaluated by stroke volume (SV). Higher CDI values and OH-PAH concentrations were detected in the exposed group. Plasma solMER and CKMB were higher in the exposed group and were associated with a reduced SV. Elevated CDI and 1-hydroxynaphthalene (1-OHNa) were associated with a higher solMER. Furthermore, increased solMER concentrations were associated with a lower SV and higher CKMB. CDI and 1-OHNa were positively associated with CKMB and mediated by solMER. In conclusion, exposure to PM2.5 and PAHs may lead to the pro-inflammatory polarization of cMacs and increase the risk of myocardial injury and systolic function impairment in children. Furthermore, the pro-inflammatory polarization of cMacs may mediate cardiotoxicity caused by PM2.5 and PAHs.
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Affiliation(s)
- Zihan Chen
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, 515000, Guangdong, China; Shantou University Medical College, Shantou, 15041, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Yu Huang
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhiheng Cheng
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhi Li
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, 515000, Guangdong, China.
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Tasmin S, Aschebrook-Kilfoy B, Hedeker D, Gopalakrishnan R, Connellan E, Kibriya MG, Young MT, Kaufman JD, Ahsan H. Long-term exposure to ambient air pollution and measures of central hemodynamics and arterial stiffness among multiethnic Chicago residents. Environ Health 2024; 23:47. [PMID: 38715087 PMCID: PMC11075200 DOI: 10.1186/s12940-024-01077-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/02/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters. METHODS We assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5 μm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes. RESULTS The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01). CONCLUSION This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.
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Affiliation(s)
- Saira Tasmin
- Department of Public Health Sciences, University of Chicago, 5815 S. Maryland Ave, Rm TC-620A, MC2000, Chicago, IL, 60637, USA
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Briseis Aschebrook-Kilfoy
- Department of Public Health Sciences, University of Chicago, 5815 S. Maryland Ave, Rm TC-620A, MC2000, Chicago, IL, 60637, USA
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, 5815 S. Maryland Ave, Rm TC-620A, MC2000, Chicago, IL, 60637, USA
| | | | - Elizabeth Connellan
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Muhammad G Kibriya
- Department of Public Health Sciences, University of Chicago, 5815 S. Maryland Ave, Rm TC-620A, MC2000, Chicago, IL, 60637, USA
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Michael T Young
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, 5815 S. Maryland Ave, Rm TC-620A, MC2000, Chicago, IL, 60637, USA.
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA.
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Li Y, Yu B, Yin L, Li X, Nima Q. Long-term exposure to particulate matter is associated with elevated blood pressure: Evidence from the Chinese plateau area. J Glob Health 2024; 14:04039. [PMID: 38483442 PMCID: PMC10939114 DOI: 10.7189/jogh.14.04039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background Ambient air pollution could increase the risk of hypertension; however, evidence regarding the relationship between long-term exposure to particulate matter and elevated blood pressure in plateau areas with lower pollution levels is limited. Methods We assessed the associations of long-term exposure to particulate matter (PM, PM1, PM2.5, and PM10) with hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP) and pulse pressure (PP) in 4.235 Tibet adults, based on the baseline of the China multi-ethnic cohort study (CMEC) in Lhasa city, Tibet from 2018-19. We used logistic regression and linear regression models to evaluate the associations of ambient PM with hypertension and blood pressure, respectively. Results Long-term exposure to PM1, PM2.5, and PM10 is positively associated with hypertension, DBP, and SBP, while negatively associated with PP. Among these air pollutants, PM10 had the strongest effect on hypertension, DBP, and SBP, while PM2.5 had the strongest effect on PP. The results showed for hypertension odds ratio (OR) = 1.99; 95% confidence interval (CI) = 1.58, 2.51 per interquartile range (IQR) μg/m3 increase in PM1, OR = 1.93; 95% CI = 1.55, 2.40 per IQR μg/m3 increase in PM2.5, and OR = 2.12; 95% CI = 1.67, 2.68 per IQR μg/m3 increase in PM10. Conclusions Long-term exposure to ambient air pollution was associated with an increased risk of hypertension, elevated SBP and DBP levels, and decreased PP levels. To reduce the risk of hypertension and PP reduction, attention should be paid to air quality interventions in plateau areas with low pollution levels.
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Affiliation(s)
- Yajie Li
- Tibet Centre for Disease Control and Prevention, Lhasa, Tibet Autonomous Region, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University – Hong Kong Polytechnic University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Yin
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Dali University, Dali, China
| | - Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Dali University, Dali, China
| | - Qucuo Nima
- Tibet Centre for Disease Control and Prevention, Lhasa, Tibet Autonomous Region, China
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Wei Y, Feng Y, Danesh Yazdi M, Yin K, Castro E, Shtein A, Qiu X, Peralta AA, Coull BA, Dominici F, Schwartz JD. Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: population based cohort study. BMJ 2024; 384:e076939. [PMID: 38383041 PMCID: PMC10879983 DOI: 10.1136/bmj-2023-076939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To estimate exposure-response associations between chronic exposure to fine particulate matter (PM2.5) and risks of the first hospital admission for major cardiovascular disease (CVD) subtypes. DESIGN Population based cohort study. SETTING Contiguous US. PARTICIPANTS 59 761 494 Medicare fee-for-service beneficiaries aged ≥65 years during 2000-16. Calibrated PM2.5 predictions were linked to each participant's residential zip code as proxy exposure measurements. MAIN OUTCOME MEASURES Risk of the first hospital admission during follow-up for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, valvular heart disease, thoracic and abdominal aortic aneurysms, or a composite of these CVD subtypes. A causal framework robust against confounding bias and bias arising from errors in exposure measurements was developed for exposure-response estimations. RESULTS Three year average PM2.5 exposure was associated with increased relative risks of first hospital admissions for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms. For composite CVD, the exposure-response curve showed monotonically increased risk associated with PM2.5: compared with exposures ≤5 µg/m3 (the World Health Organization air quality guideline), the relative risk at exposures between 9 and 10 µg/m3, which encompassed the US national average of 9.7 µg/m3 during the study period, was 1.29 (95% confidence interval 1.28 to 1.30). On an absolute scale, the risk of hospital admission for composite CVD increased from 2.59% with exposures ≤5 µg/m3 to 3.35% at exposures between 9 and 10 µg/m3. The effects persisted for at least three years after exposure to PM2.5. Age, education, accessibility to healthcare, and neighborhood deprivation level appeared to modify susceptibility to PM2.5. CONCLUSIONS The findings of this study suggest that no safe threshold exists for the chronic effect of PM2.5 on overall cardiovascular health. Substantial benefits could be attained through adherence to the WHO air quality guideline.
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Affiliation(s)
- Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Yijing Feng
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Kanhua Yin
- Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Alexandra Shtein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Adjani A Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Tasmin S, Aschebrook-Kilfoy B, Hedeker D, Gopalakrishnan R, Stepniak E, Kibriya MG, Young MT, Kaufman JD, Ahsan H. Long-term exposure to ambient air pollution and measures of central hemodynamics and arterial stiffness among multiethnic Chicago residents. RESEARCH SQUARE 2023:rs.3.rs-3171526. [PMID: 37503099 PMCID: PMC10371125 DOI: 10.21203/rs.3.rs-3171526/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Objectives To examine whether air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters. Methods We assessed central hemodynamic parameters, brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5μm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes. Results The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-μg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01). Conclusion This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.
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Vaičiulis V, Venclovienė J, Miškinytė A, Ustinavičienė R, Dėdelė A, Kalinienė G, Lukšienė D, Tamošiūnas A, Seiduanova L, Radišauskas R. Association between Outdoor Air Pollution and Fatal Acute Myocardial Infarction in Lithuania between 2006 and 2015: A Time Series Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4549. [PMID: 36901560 PMCID: PMC10002310 DOI: 10.3390/ijerph20054549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period. METHODS The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR. RESULTS It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00-1.12) and women (RR 1.12; 95% CI 1.02-1.22) when the concentration of PM10 in the ambient air was increased 5-11 days before the onset of AMI, adjusting for NO2 concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03-1.22), in men (RR 1.13; 95% CI 1.01-1.26), in younger-aged (RR 1.15; 95% CI 1.03-1.28), and in winter in women (RR 1.24; 95% CI 1.03-1.50). CONCLUSIONS Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM10 specifically.
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Affiliation(s)
- Vidmantas Vaičiulis
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Jonė Venclovienė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Rūta Ustinavičienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Gintarė Kalinienė
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Dalia Lukšienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Laura Seiduanova
- Department of Health Politics and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
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Niu Z, Duan Z, Yu H, Xue L, Liu F, Yu D, Zhang K, Han D, Wen W, Xiang H, Qin W. Association between long-term exposure to ambient particulate matter and blood pressure, hypertension: an updated systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:268-283. [PMID: 34983264 DOI: 10.1080/09603123.2021.2022106] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
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, PM2.5 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, PM2.5 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, PM2.5, 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, PM2.5 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.
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Affiliation(s)
- Zhiping Niu
- Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, Affiliated People's Hospital of Nanchang University, Jiangxi, China
| | - Hongmei Yu
- Pukou District Center for Disease Control and Prevention, Nanjing, China
| | - Lina Xue
- Department of Medical Affairs, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Feifei Liu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Dong Yu
- Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Keying Zhang
- Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Donghui Han
- Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Weihong Wen
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
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9
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Mei Y, Zhao J, Zhou Q, Zhao M, Xu J, Li Y, Li K, Xu Q. Residential greenness attenuated association of long-term air pollution exposure with elevated blood pressure: Findings from polluted areas in Northern China. Front Public Health 2022; 10:1019965. [PMID: 36249254 PMCID: PMC9557125 DOI: 10.3389/fpubh.2022.1019965] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023] Open
Abstract
Background Evidence on the hypertensive effects of long-term air pollutants exposure are mixed, and the joint hypertensive effects of air pollutants are also unclear. Sparse evidence exists regarding the modifying role of residential greenness in such effects. Methods A cross-sectional study was conducted in typically air-polluted areas in northern China. Particulate matter with diameter < 1 μm (PM1), particulate matter with diameter < 2.5 μm (PM2.5), particulate matter with diameter < 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were predicted by space-time extremely randomized trees model. We used the Normalized Difference Vegetation Index (NDVI) to reflect residential green space. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were examined. We also calculated the pulse pressure (PP) and mean arterial pressure (MAP). Generalized additive model and quantile g-computation were, respectively, conducted to investigate individual and joint effects of air pollutants on blood pressure. Furthermore, beneficial effect of NDVI and its modification effect were explored. Results Long-term air pollutants exposure was associated with elevated DBP and MAP. Specifically, we found a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 2.36% (95% CI: 0.97, 3.76), 1.51% (95% CI: 0.70, 2.34), and 3.54% (95% CI: 1.55, 5.56) increase in DBP; a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 1.84% (95% CI: 0.74, 2.96), 1.17% (95% CI: 0.52, 1.83), and 2.43% (95% CI: 0.71, 4.18) increase in MAP. Air pollutants mixture (one quantile increase) was positively associated with increased values of DBP (8.22%, 95% CI: 5.49, 11.02) and MAP (4.15%, 95% CI: 2.05, 6.30), respectively. These identified harmful effect of air pollutants mainly occurred among these lived with low NDVI values. And participants aged ≥50 years were more susceptible to the harmful effect of PM2.5 and PM10 compared to younger adults. Conclusions Our study indicated the harmful effect of long-term exposure to air pollutants and these effects may be modified by living within higher green space place. These evidence suggest increasing residential greenness and air pollution control may have simultaneous effect on decreasing the risk of hypertension.
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Affiliation(s)
- Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China,Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China,*Correspondence: Qun Xu
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10
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Li B, Cao H, Liu K, Xia J, Sun Y, Peng W, Xie Y, Guo C, Liu X, Wen F, Zhang F, Shan G, Zhang L. Associations of long-term ambient air pollution and traffic-related pollution with blood pressure and hypertension defined by the different guidelines worldwide: the CHCN-BTH study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:63057-63070. [PMID: 35449329 DOI: 10.1007/s11356-022-20227-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
The assessment of the generalization of the strict hypertension definition in the 2017 ACC/AHA Hypertension Guideline from environmental condition remains sparse. The aims of this study are to investigate and compare the associations of ambient air pollution and traffic-related pollution (TRP) with hypertension defined by the different criteria. A total of 32,135 participants were recruited from the baseline survey of the CHCN-BTH in 2017. We defined hypertension as SBP/DBP ≥ 140/90 mmHg according to the hypertension guidelines in China, Japan, Europe and ISH (traditional criteria) and defined as SBP/DBP ≥ 130/80 mmHg according to the 2017 ACC/AHA Hypertension Guideline (strict criteria). A two-level generalized linear mixed models were applied to investigate the associations of air pollutants (i.e. PM2.5, SO2, NO2) and TRP with blood pressure (BP) measures and hypertension. Stratified analyses and two-pollutant models were also performed. The stronger associations of air pollutants were found in the hypertension defined by the strict criteria than that defined by the traditional criteria. The ORs per an IQR increase in PM2.5 were 1.17 (95% CI: 1.09, 1.25) for the strict criteria and 1.14 (95% CI: 1.06, 1.23) for the traditional criteria. The similar conditions were also observed for TRP. The above results were robust in both stratified analyses and two-pollutant models. Our study assessed the significance of the hypertension defined by the strict criteria from environmental aspect and called attention to the more adverse effects of air pollution and TRP on the earlier stage of hypertension.
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Affiliation(s)
- Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Kuo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Juan Xia
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Fuyuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Fengxu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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11
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Weng Z, Liu Q, Yan Q, Liang J, Zhang X, Xu J, Li W, Xu C, Gu A. Associations of genetic risk factors and air pollution with incident hypertension among participants in the UK Biobank study. CHEMOSPHERE 2022; 299:134398. [PMID: 35339527 DOI: 10.1016/j.chemosphere.2022.134398] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/19/2022] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
The purposes of this study were to quantify the association of the combination of air pollution and genetic risk factors with hypertension and explore the interactions between air pollution and genetic risk. This study included 391,366 participants of European ancestry initially free from pre-existing hypertension in the UK Biobank. Exposure to ambient air pollutants, including particulate matter (PM2.5 PM2.5-10, and PM10), nitrogen dioxide (NO2) and nitrogen oxides (NOX), was estimated through land use regression modelling, and the associations between air pollutants and the incidence of hypertension were investigated using a Cox proportional hazards model adjusted for covariates. Furthermore, we established a polygenic risk score for hypertension and assessed the combined effect of genetic susceptibility and air pollution on incident hypertension. The results showed significant associations between the risk of hypertension and exposure to PM2.5 (hazard ratio [HR]: 1.41, 95% confidence interval [CI]: 1.29-1.53; per 10 μg/m3), PM10 (1.05, 1.00-1.09; per 10 μg/m3), and NOX (1.01, 1.01-1.02 per 10 μg/m3). Additive effects of PM2.5 and NOX exposure and genetic risk were observed. Compared to individuals with a low genetic risk and low air pollution exposure, participants with high air pollution exposure and a high genetic risk had a significantly increased risk of hypertension (PM2.5: 71% (66%-76%), PM10: 59% (55%-64%), NOX: 65% (60%-70%)). Our results indicate that long-term exposure to air pollution is associated with an increased risk of hypertension, especially in individuals with a high genetic risk.
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Affiliation(s)
- Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Qing Yan
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jingjia Liang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China; Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wenxiang Li
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.
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12
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Zhao M, Xu Z, Guo Q, Gan Y, Wang Q, Liu JA. Association between long-term exposure to PM 2.5 and hypertension: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL RESEARCH 2022; 204:112352. [PMID: 34762927 DOI: 10.1016/j.envres.2021.112352] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Numerous studies have examined the association between long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) 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 PM2.5 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 PM2.5 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 PM2.5 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 PM2.5 and hypertension incidence (p for interaction = 0.042) and that the PM2.5 concentration level and physical activity had a noticeable effect on the association of PM2.5 and hypertension prevalence (p for interaction = 0.005; p for interaction = 0.022). CONCLUSIONS A significantly positive correlation was observed between long-term PM2.5 exposure and risks of hypertension incidence and prevalence, and a high PM2.5 concentration resulted in an increased risk of hypertension.
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Affiliation(s)
- Mingqing Zhao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ziyuan Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qianqian Guo
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-An Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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13
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Wensu Z, Wen C, Fenfen Z, Wenjuan W, Li L. The Association Between Long-Term Exposure to Particulate Matter and Incidence of Hypertension Among Chinese Elderly: A Retrospective Cohort Study. Front Cardiovasc Med 2022; 8:784800. [PMID: 35087881 PMCID: PMC8788195 DOI: 10.3389/fcvm.2021.784800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Background and Objectives: Studies that investigate the links between particulate matter ≤2. 5 μm (PM2.5) and hypertension among the elderly population, especially those including aged over 80 years, are limited. Therefore, we aimed to examine the association between PM2.5 exposure and the risk of hypertension incidence among Chinese elderly. Methods: This prospective cohort study used 2008, 2011, 2014, and 2018 wave data from a public database, the Chinese Longitudinal Healthy Longevity Survey, a national survey investigating the health of those aged over 65 years in China. We enrolled cohort participants who were free of hypertension at baseline (2008) from 706 counties (districts) and followed up in the 2011, 2014, and 2018 survey waves. The annual PM2.5 concentration of 706 counties (districts) units was derived from the Atmospheric Composition Analysis Group database as the exposure variable, and exposure to PM2.5 was defined as 1-year average of PM2.5 concentration before hypertension event occurrence or last interview (only for censoring). A Cox proportional hazards model with penalized spline was used to examine the non-linear association between PM2.5 concentration and hypertension risk. A random-effects Cox proportional hazards model was built to explore the relationship between each 1 μg/m3, 10 μg/m3 and quartile increment in PM2.5 concentration and hypertension incidence after adjusting for confounding variables. The modification effects of the different characteristics of the respondents were also explored. Results: A total of 7,432 participants aged 65-116 years were enrolled at baseline. The median of PM2.5 exposure concentration of all the participants was 52.7 (inter-quartile range, IQR = 29.1) μg/m3. Overall, the non-linear association between PM2.5 and hypertension incidence risk indicated that there was no safe threshold for PM2.5 exposure. The higher PM2.5 exposure, the greater risk for hypertension incidence. Each 1 μg/m3 [adjusted hazard ratio (AHR): 1.01; 95% CI: 1.01-1.02] and 10 μg/m3 (AHR: 1.12; 95% CI: 1.09-1.16) increments in PM2.5, were associated with the incidence of hypertension after adjusting for potential confounding variables. Compared to first quartile (Q1) exposure, the adjusted HRs of hypertension incidence for the Q2, Q3 and Q4 exposure of PM2.5 were 1.31 (95% CI: 1.13-1.51), 1.35 (95% CI: 1.15-1.60), and 1.83 (95% CI: 1.53-2.17), respectively. The effects appear to be stronger among those without a pension, living in a rural setting, and located in central/western regions. Conclusion: We found no safe threshold for PM2.5 exposure related to hypertension risk, and more rigorous approaches for PM2.5 control were needed. The elderly without a pension, living in rural and setting in the central/western regions may be more vulnerable to the effects of PM2.5 exposure.
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Affiliation(s)
- Zhou Wensu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chen Wen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhou Fenfen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wang Wenjuan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ling Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
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14
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Zhou W, Wang W, Fan C, Zhou F, Ling L. Residential elevation and its effects on hypertension incidence among older adults living at low altitudes: a prospective cohort study. Environ Health Prev Med 2022; 27:19. [PMID: 35527011 PMCID: PMC9251620 DOI: 10.1265/ehpm.22-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Research on the relationship between residential altitude and hypertension incidence has been inconclusive. Evidence at low altitudes (i.e., <1,500 m) is scarce, let alone in older adults, a population segment with the highest hypertension prevalence. Thus, the objective of this study is to determine whether hypertension risk may be affected by altitude in older adults living at low altitudes. Methods This prospective cohort study collected data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We selected 6,548 older adults (≥65 years) without hypertension at baseline (2008) and assessed events by the follow-up surveys done in 2011, 2014, and 2018 waves. The mean altitude of 613 residential units (county or district) in which the participants resided was extracted from the Digital Elevation Model (DEM) of the National Aeronautics and Space Administration (NASA) and was accurate to within 30 m. The Cox regression model with penalized splines examined the linear or nonlinear link between altitude and hypertension. A random-effects Cox regression model was used to explore the linear association between altitude and hypertension. Results The overall rate of incident hypertension was 8.6 per 100-person years. The median altitude was 130.0 m (interquartile range [IQR] = 315.5 m). We observed that the exposure–response association between altitude and hypertension incidence was not linear. The shape of the exposure–response curve showed that three change points existed. Hypertension risk increased from the lowest to the first change point (247.1 m) and slightly fluctuated until the last change point (633.9 m). The risk decreased above the last change point. According to the categories stratified by the change points, altitude was only significantly associated with hypertension risk (hazard ratio [HR] = 1.003; 95% confidence interval [CI] = 1.002–1.005) under the first change point (247.1 m) after adjusting for related covariates. Conclusion Our study found that the association between altitude and hypertension risk might not be linear. We hope the further study can be conducted to confirm the generality of our findings. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00001.
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Affiliation(s)
- Wensu Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University
| | - Wenjuan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University
| | - Chaonan Fan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University
| | - Fenfen Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University
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15
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Konduracka E, Rostoff P. Links between chronic exposure to outdoor air pollution and cardiovascular diseases: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2022; 20:2971-2988. [PMID: 35496466 PMCID: PMC9036845 DOI: 10.1007/s10311-022-01450-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/04/2022] [Indexed: 05/10/2023]
Abstract
Acute exposure to air pollution is associated with an increasing risk of death and cardiovascular disorders. Nonetheless, the impact of chronic exposure to air pollution on the circulatory system is still debated. Here, we review the links of chronic exposure to outdoor air pollution with mortality and most common cardiovascular diseases, in particular during the coronavirus disease 2019 event (COVID-19). We found that recent studies provide robust evidence for a causal effect of chronic exposure to air pollution and cardiovascular mortality. In terms of mortality, the strongest relationship was noted for fine particulate matter, nitrogen dioxide, and ozone. There is also increasing evidence showing that exposure to air pollution, mainly fine particulate matter and nitrogen dioxide, is associated with the development of atherosclerosis, hypertension, stroke, and heart failure. However, available scientific evidence is not strong enough to support associations with cardiac arrhythmias and coagulation disturbances. Noteworthy, for some pollutants, the risk of negative health effects is high for concentrations lower than the limit values recommended by the European Union and Word Health Organization. Efforts to diminish exposure to air pollution and to design optimal methods of air pollution reduction should be urgently intensified and supported by effective legislation and interdisciplinary cooperation.
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Affiliation(s)
- Ewa Konduracka
- Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Paweł Rostoff
- Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
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16
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Song J, Gao Y, Hu S, Medda E, Tang G, Zhang D, Zhang W, Li X, Li J, Renzi M, Stazi MA, Zheng X. Association of long-term exposure to PM 2.5 with hypertension prevalence and blood pressure in China: a cross-sectional study. BMJ Open 2021; 11:e050159. [PMID: 34887274 PMCID: PMC8663071 DOI: 10.1136/bmjopen-2021-050159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Evidence of the effects of long-term fine particulate matter (PM2.5) exposure on hypertension and blood pressure is limited for populations exposed to high levels of PM2.5. We aim to assess associations of long-term exposure to PM2.5 with hypertension prevalence and blood pressure, and further explore the subpopulation differences and effect modification by participant characteristics in these associations in China. METHODS We analysed cross-sectional data from 883 827 participants aged 35-75 years in the China Patient-Centred Evaluative Assessment of Cardiac Events Million Persons Project. Data from the monitoring station were used to estimate the 1-year average concentration of PM2.5. The associations of PM2.5 exposure with hypertension prevalence and blood pressure were investigated by generalised linear models, with PM2.5 included as either linear or spline functions. RESULTS The 1-year PM2.5 exposure of the study population ranged from 8.8 to 93.8 µg/m3 (mean 49.2 µg/m3). The adjusted OR of hypertension prevalence related to a 10 μg/m3 increase in 1-year PM2.5 exposure was 1.04 (95% CI, 1.02 to 1.05). Each 10 μg/m3 increment in PM2.5 exposure was associated with increases of 0.19 mm Hg (95% CI, 0.10 to 0.28) and 0.13 mm Hg (95% CI, 0.08 to 0.18) in systolic blood pressure and diastolic blood pressure, respectively. The concentration-response curves for hypertension prevalence and systolic blood pressure showed steeper slopes at higher PM2.5 levels; while the curve for diastolic blood pressure was U-shaped. The elderly, men, non-current smokers and obese participants were more susceptible to the exposure of PM2.5. CONCLUSIONS Long-term exposure to PM2.5 is associated with higher blood pressure and increased risk of hypertension prevalence. The effects of PM2.5 on hypertension prevalence become more pronounced at higher PM2.5 levels. These findings emphasise the need to reduce air pollution, especially in areas with severe air pollution.
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Affiliation(s)
- Jiali Song
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Yan Gao
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Shuang Hu
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Emanuela Medda
- Reference Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Guigang Tang
- China National Environmental Monitoring Centre, State Environmental Protection Key Laboratory of Quality Control in Environmental Monitoring, Ministry of Ecology and Environment of the People's Republic of China, Beijing, China
| | - Di Zhang
- China National Environmental Monitoring Centre, State Environmental Protection Key Laboratory of Quality Control in Environmental Monitoring, Ministry of Ecology and Environment of the People's Republic of China, Beijing, China
| | - Wenbo Zhang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Matteo Renzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Maria Antonietta Stazi
- Reference Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Xin Zheng
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
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Qin P, Luo X, Zeng Y, Zhang Y, Li Y, Wu Y, Han M, Qie R, Wu X, Liu D, Huang S, Zhao Y, Feng Y, Yang X, Hu F, Sun X, Hu D, Zhang M. Long-term association of ambient air pollution and hypertension in adults and in children: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 796:148620. [PMID: 34274662 DOI: 10.1016/j.scitotenv.2021.148620] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
AIMS The association of long-term ambient air pollution and hypertension has been inconsistently reported. We performed an updated systematic review and meta-analysis to assess the association between long-term exposure to ambient air pollution and risk of hypertension in adults and in children. METHODS PubMed, EMBASE, and Web of Science were searched up to August 7, 2020 for published articles examining the association of long-term exposure to ambient air pollution, including particulate matter (PM; ultrafine particles, PM1, PM1-2.5, PM2.5, PM2.5-10 and PM10), nitrogen dioxide (NO2), nitrogen oxides (NOx), sulfur dioxide (SO2), ozone (O3), carbon monoxide (CO) and hypertension. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension with each 10-μg/m3 increase in air pollutants were calculated by random-effects models. RESULTS We included 57 studies (53 of adults and 4 of children) in the meta-analysis. Risk of hypertension was significantly increased in adults with each 10-μg/m3 increase in exposure to PM2.5 (OR 1.10, 95% CI 1.07-1.14; I2 = 93.1%; n = 37), PM10 (1.04, 1.02-1.07; I2 = 44.8%; n = 22), and SO2 (1.21, 1.08-1.36; I2 = 96.6%; n = 3). Hypertension was not significantly associated with PM1 (n = 2), PM2.5-10 (n = 16), NO2 (n = 27), or NOx (n = 17). In children, the summary ORs (95% CIs) for each 10-μg/m3 increase in PM2.5, PM10, SO2 and O3 were 2.82 (0.51-15.68; I2 = 83.8%; n = 2), 1.15 (1.01-1.32; I2 = 0; n = 2), 8.57 (0.13-575.58; I2 = 94.2%; n = 2), and 1.26 (0.81-1.09, I2 = 91.6%; n = 2), respectively. CONCLUSIONS Long-term ambient air pollution is a potential risk factor for hypertension in adults. More studies are needed to explore the effects of long-term air pollution on hypertension in children.
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Affiliation(s)
- Pei Qin
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China
| | - Xinping Luo
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China
| | - Yunhong Zeng
- Department of Health Management, Shenzhen Hospital of University of Chinese Academy of Sciences, Shenzhen, China
| | - Yanyan Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China; The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China
| | - Minghui Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Ranran Qie
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Xiaoyan Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China; Department of Health Management, Shenzhen Hospital of University of Chinese Academy of Sciences, Shenzhen, China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Shengbing Huang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China; The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.
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18
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Wu Y, Ye Z, Fang Y. Spatial analysis of the effects of PM2.5 on hypertension among the middle-aged and elderly people in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:729-740. [PMID: 31646877 DOI: 10.1080/09603123.2019.1682528] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Hypertension is currently one of the most common chronic diseases with high global prevalence associated with a huge social and economic burden. In recent years, air pollution has become a focus of research, especially the effects of PM2.5 on hypertension. However, few studies have considered the spatial properties of the sample; thus, the results might be unreliable. Based on the China Health and Retirement Longitudinal Study (CHARLS) and the Environmental Status Bulletin for each province in China, we used the extended shared component model (SCM) to fit the spatial variation of hypertension risk and to reveal the impact of PM2.5 on hypertension in males and females. Our results revealed that the crude prevalence of hypertension for the whole population in China was 32.74% in 2015, with the prevalence in men experiencing slightly higher than that in women (32.92% vs. 32.58%). We found that the distribution of hypertension prevalence exhibited obvious spatial aggregation for the whole population in China (Moran's I = 0.39, P = 0.001), with similar results in both men (Moran's I = 0.18, P = 0.027) and women (Moran's I = 0.52, P = 0.001). Furthermore, the smoothed results obtained using the SCM indicated that some eastern and central provinces had relatively higher hypertension risk, while the risk in southeastern provinces was much lower. The risk was also relatively lower in most western provinces, except for some northwestern regions. Notably, our results showed that PM2.5 was a risk factor for hypertension, and the impact of PM2.5 on women was slightly greater than that on men, with odds ratios (OR) of 1.063 (1.041, 1.086) and 1.048 (1.025, 1.071), respectively. Our findings suggest the existence of distinct spatial differences in the prevalence of hypertension and small sex-related differences in the risk of hypertension in China.
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Affiliation(s)
- Yafei Wu
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Zirong Ye
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
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19
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Evaluation of Using Satellite-Derived Aerosol Optical Depth in Land Use Regression Models for Fine Particulate Matter and Its Elemental Composition. ATMOSPHERE 2021. [DOI: 10.3390/atmos12081018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study introduced satellite-derived aerosol optical depth (AOD) in land use regression (LUR) modeling to predict ambient concentrations of fine particulate matter (PM2.5) and its elemental composition. Twenty-four daily samples were collected from 17 air quality monitoring sites (N = 408) in Taiwan in 2014. A total of 12 annual LUR models were developed for PM2.5 and 11 elements, including aluminum, calcium, chromium, iron, potassium, manganese, sulfur, silicon, titanium, vanadium, and zinc. After applied AOD and a derived-predictor, AOD percentage, in modeling, the number of models with leave-one-out cross-validation R2 > 0.40 significantly increased from 5 to 9, indicating the substantial benefits for the construction of spatial prediction models. Sensitivity analyses of using data stratified by PM2.5 concentrations revealed that the model performances were further improved in the high pollution season.
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20
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Du J, Shao B, Gao Y, Wei Z, Zhang Y, Li H, Wang J, Shi Y, Su J, Liu Q, Liu Y, Wang P, Xie C, Wang C, Guo X, Li G. Associations of long-term exposure to air pollution with blood pressure and homocysteine among adults in Beijing, China: A cross-sectional study. ENVIRONMENTAL RESEARCH 2021; 197:111202. [PMID: 33894236 DOI: 10.1016/j.envres.2021.111202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/13/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
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 (PM2.5), 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 PM2.5 (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 PM2.5, 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.
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Affiliation(s)
- Jing Du
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China; Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Bing Shao
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Yanlin Gao
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Zaihua Wei
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Yu Zhang
- Zhendui Industry Artificial Intelligence Co. Ltd, Beijing, 518101, China
| | - Hong Li
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Jing Wang
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Yunping Shi
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Jianting Su
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Qingping Liu
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Yang Liu
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Ping Wang
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Chunyan Xie
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Chao Wang
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Gang Li
- Beijing Centre for Disease Prevention and Control, Beijing, 100013, China.
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21
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Ho CC, Chen YC, Tsai MH, Tsai HT, Weng CY, Yet SF, Lin P. Ambient Particulate Matter Induces Vascular Smooth Muscle Cell Phenotypic Changes via NOX1/ROS/NF-κB Dependent and Independent Pathways: Protective Effects of Polyphenols. Antioxidants (Basel) 2021; 10:antiox10050782. [PMID: 34069133 PMCID: PMC8156007 DOI: 10.3390/antiox10050782] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies have demonstrated an association between ambient particulate matter (PM) exposure and vascular diseases. Here, we observed that treatment with ambient PM increased cell migration ability in vascular smooth muscle cells (VSMCs) and pulmonary arterial SMCs (PASMCs). These results suggest that VSMCs and PASMCs transitioned from a differentiated to a synthetic phenotype after PM exposure. Furthermore, treatment with PM increased intracellular reactive oxygen species (ROS), activated the NF-κB signaling pathway, and increased the expression of proinflammatory cytokines in VSMCs. Using specific inhibitors, we demonstrated that PM increased the migration ability of VSMCs via the nicotinamide–adenine dinucleotide phosphate (NADPH) oxidase 1 (NOX1)/ROS-dependent NF-κB signaling pathway, which also partially involved in the induction of proinflammatory cytokines. Finally, we investigated whether nature polyphenolic compounds prevent PM-induced migration and proinflammatory cytokines secretion in VSMCs. Curcumin, resveratrol, and gallic acid prevented PM2.5-induced migration via the ROS-dependent NF-κB signaling pathway. However, honokiol did not prevent PM2.5-induced migration or activation of the ROS-dependent NF-κB signaling pathway. On the other hand, all polyphenols prevented PM2.5-induced cytokines secretion. These data indicated that polyphenols prevented PM-induced migration and cytokine secretion via blocking the ROS-dependent NF-κB signaling pathway in VSMCs. However, other mechanisms may also contribute to PM-induced cytokine secretion.
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Affiliation(s)
- Chia-Chi Ho
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
| | - Yu-Cheng Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
| | - Ming-Hsien Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
| | - Hui-Ti Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
| | - Chen-Yi Weng
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
| | - Shaw-Fang Yet
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan 53053, Taiwan
- Correspondence: (S.-F.Y.); (P.L.); Tel.: +886-37-246166 (ext. 38311) (S.-F.Y.); +886-37-246166 (ext. 36508) (P.L.)
| | - Pinpin Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 53053, Taiwan; (C.-C.H.); (Y.-C.C.); (M.-H.T.); (H.-T.T.); (C.-Y.W.)
- Correspondence: (S.-F.Y.); (P.L.); Tel.: +886-37-246166 (ext. 38311) (S.-F.Y.); +886-37-246166 (ext. 36508) (P.L.)
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22
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Ye JJ, Wang SS, Fang Y, Zhang XJ, Hu CY. Ambient air pollution exposure and risk of chronic kidney disease: A systematic review of the literature and meta-analysis. ENVIRONMENTAL RESEARCH 2021; 195:110867. [PMID: 33582130 DOI: 10.1016/j.envres.2021.110867] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/07/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
Ambient air pollution has been identified as one of the leading causes of global burden of disease. The relationship between ambient air pollution exposure and risk of chronic kidney disease (CKD) has stimulated increasing scientific interest in the past few years. However, evidence from human epidemiological studies is still limited and inconsistent. We performed an updated systematic review and meta-analysis to clarify the potential association comprehensively. Selected electronic databases were searched for related English language studies until March 1, 2020 with a final follow-up in December 31, 2020. Risk of bias assessment for individual studies were assessed using the OHAT (Office of Health Assessment and Translation) risk-of-bias rating tool. Confidence rating and level-of-evidence conclusions were developed for bodies of evidence for a given ambient air pollutant. Summary effect estimates were calculated using random-effects meta-analyses when three or more studies are identified for the same air pollutant-CKD combination. A total of 13 studies were finally identified in our study. The meta-analytic estimates (ORs) for risk of CKD were 1.15 (95% CI: 1.07, 1.24) for each 10 μg/m3 increase in PM2.5, 1.25 (95% CI: 1.11, 1.40) for each 10 μg/m3 increase in PM10, 1.10 (95% CI: 1.03, 1.17) for each 10 ppb increase in NO2, 1.06 (95% CI: 0.98, 1.15) for each 1 ppb increase in SO2 and 1.04 (95% CI: 1.00, 1.08) for each 0.1 ppm increase in CO, respectively. The level of evidence was appraised as moderate for four of the five tested air pollutant-CKD combinations using an adaptation of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool. In conclusion, this study suggests that certain ambient air pollutant exposure was significantly associated with an increased risk of CKD. Given the limitations, the results of this study should be interpreted with caution, and further well-designed epidemiological studies are needed to draw a definite evidence of a causal relationship.
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Affiliation(s)
- Jia-Jia Ye
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Shu-Si Wang
- Department of Healthcare-associated Infection Management, Hefei Stomatological Hospital, Anhui Medical University Hefei Oral Clinic College, 265 Changjiang Middle Road, Hefei, 230001, China
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA Rotterdam, the Netherlands
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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23
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Du X, Zhang Y, Liu C, Fang J, Zhao F, Chen C, Du P, Wang Q, Wang J, Shi W, van Donkelaar A, Martin RV, Bachwenkizi J, Chen R, Li T, Kan H, Shi X. Fine particulate matter constituents and sub-clinical outcomes of cardiovascular diseases: A multi-center study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:143555. [PMID: 33189387 DOI: 10.1016/j.scitotenv.2020.143555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/20/2020] [Accepted: 10/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Limited evidence is available on the associations of long-term exposure to various fine particulate matter (PM2.5) constituents with sub-clinical outcomes of cardiovascular disease (CVD) in China. OBJECTIVES We aimed to explore the associations of PM2.5 and its constituents with blood pressure (BP), fasting glucose, and cardiac electrophysiological (ECG) properties based on a national survey of 5852 Chinese adults, who participated in the Sub-Clinical Outcome of Polluted Air study, from July 2017 to March 2019. METHODS Annual residential exposure to PM2.5 and its constituents of each subject was predicted by a satellite-based mode. We assessed the associations between five main constituents [organic matter (OM), black carbon (BC), sulfate (SO42-), nitrate (NO3-), ammonium (NH4+)] of PM2.5 and systolic BP (SBP), diastolic BP (DBP), fasting glucose, and ECG measurements (PR, QRS, QT, and QTc interval) using multivariable linear regression models. RESULTS Long-term PM2.5 exposure was significantly associated with increased levels of fasting glucose, DBP, and ECG measurements. An IQR increase in OM (8.2 μg/m3) showed considerably stronger associations with an elevated fasting glucose of 0.39 mmol/L (95%CI confidence interval: 0.28, 0.49) compared with other PM2.5 constituents. Meanwhile, an IQR increase in NO3-, NH4+ and OM had stronger associations with DBP and ECG parameters compared with BC and SO42-. CONCLUSIONS This nationwide multi-center study in China indicated that some constituents (i.e., OM, NO3-, and NH4+) might be mainly responsible for the association of PM2.5 with sub-clinical outcomes of CVD including BP, fasting glucose, and ECG measurements.
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Affiliation(s)
- Xihao Du
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Jianlong Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Peng Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qiong Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jiaonan Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Wanying Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, B3H 4R2 Halifax, Nova Scotia, Canada
| | - Jovine Bachwenkizi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Lan C, Liu Y, Li Q, Wang B, Xue T, Chen J, Jiangtulu B, Ge S, Wang X, Gao M, Yu Y, Xu Y, Zhao X, Li Z. Internal metal(loid)s are potentially involved in the association between ambient fine particulate matter and blood pressure: A repeated-measurement study in north China. CHEMOSPHERE 2021; 267:129146. [PMID: 33338725 DOI: 10.1016/j.chemosphere.2020.129146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
The effects of ambient fine particulate matter (PM2.5) exposure on blood pressure have been widely reported. However, there remains uncertainty regarding the underlying roles of particulate matter components. We aimed to investigate the association between ambient PM2.5 exposure and blood pressure, as well as the potential effects of trace metal(loid)s, in a repeated-measurement study that enrolled women of childbearing age. Our study included 35 participants from Hebei Province, China, each of whom was visited for five times. During each visit, we conducted questionnaire surveys, measured blood pressure, and collected blood. The daily PM2.5 exposure of participants was estimated according to their residential addresses using a spatiotemporal model that combined monitoring data with satellite measurements and chemical-transport model simulations. This model was used to calculate average PM2.5 concentrations in 1, 3, 7, 15, 30, and 60 days prior to each visit. Serum concentrations of various trace metal(loid)s were measured. A linear mixed-effects model was used to investigate associations among study variables. Overall, the mean (standard deviation) 60 days PM2.5 concentration over all five visits was 108.1(43.3) μg/m3. PM2.5 concentration was positively associated with both systolic and diastolic blood pressures. Likewise, ambient PM2.5 concentration was positively associated with serum concentrations of manganese and arsenic, and negatively associated with serum concentrations of nickel, tin, and chromium. Only the serum concentration of molybdenum was negatively associated with systolic blood pressure. We concluded that ambient PM2.5 exposure may contribute to elevated blood pressure, potentially by interfering with internal intake of various metal(loid)s in the human body.
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Affiliation(s)
- Changxin Lan
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Yingying Liu
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Qi Li
- Jiangxi Environmental Engineering Vocational College, Ganzhou City, 341002, PR China
| | - Bin Wang
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China.
| | - Tao Xue
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Junxi Chen
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Bahabaike Jiangtulu
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Shufang Ge
- School of Environment, Beijing Normal University, Beijing, 100875, PR China
| | - Xuepeng Wang
- School of Environment, Beijing Normal University, Beijing, 100875, PR China
| | - Miaomiao Gao
- School of Environment, Beijing Normal University, Beijing, 100875, PR China
| | - Yanxin Yu
- School of Environment, Beijing Normal University, Beijing, 100875, PR China.
| | - Ying Xu
- Department of Building Science, Tsinghua University, Beijing, 100084, PR China
| | - Xiuge Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, PR China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, 100191, PR China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
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Long-term exposure to high particulate matter pollution and incident hypertension: a 12-year cohort study in northern China. J Hum Hypertens 2021; 35:1129-1138. [PMID: 33462392 DOI: 10.1038/s41371-020-00443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 10/10/2020] [Accepted: 11/01/2020] [Indexed: 01/10/2023]
Abstract
Numerous cohort studies have reported the association of long-term exposure to particulate matter <10 μm in diameter (PM10) and hypertension in American and European countries. However, these results have been inconsistent and subject to various confounding factors. The study aimed to explore the effect of long-term exposure to high-level concentrations of PM10 on incident hypertension in a large-scale cohort from northern China. A retrospective cohort study of 39,054 participants aged between 23 and 98 years old from four cities in northern China was followed from 1998 to 2009. Excluding those with hypertension, 37,386 non-hypertensive participants (overall population) were followed for self-reported hypertension. The individuals' exposure to PM10 was the mean concentration during the follow-up period, according to the data of local environmental monitoring centers. Hazard ratios (HRs) were calculated by Cox proportional hazards models. The adjusted potential confounding factors included sociodemographic information, lifestyle, and diet. There were 2619 (7.0%) incident cases of hypertension among the overall population. In multivariable models, the HR (95% CI) of incident hypertension was 1.537 (1.515, 1.560) for each 10 μg/m3 increase in PM10. Stratified analyses showed individuals (age <65) were prone to developing hypertension. Moreover, the effects of PM10 increased and produced an HR (95% CI) of 1.555 (1.527, 1.584) for the healthy population in the sensitivity analysis. We found that the association between long-term exposure to PM10 air pollution and incident hypertension was significantly positive.
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Paoin K, Ueda K, Ingviya T, Buya S, Phosri A, Seposo XT, Seubsman SA, Kelly M, Sleigh A, Honda A, Takano H. Long-term air pollution exposure and self-reported morbidity: A longitudinal analysis from the Thai cohort study (TCS). ENVIRONMENTAL RESEARCH 2021; 192:110330. [PMID: 33068582 PMCID: PMC7768181 DOI: 10.1016/j.envres.2020.110330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Several studies have shown the health effects of air pollutants, especially in China, North American and Western European countries. But longitudinal cohort studies focused on health effects of long-term air pollution exposure are still limited in Southeast Asian countries where sources of air pollution, weather conditions, and demographic characteristics are different. The present study examined the association between long-term exposure to air pollution and self-reported morbidities in participants of the Thai cohort study (TCS) in Bangkok metropolitan region (BMR), Thailand. METHODS This longitudinal cohort study was conducted for 9 years from 2005 to 2013. Self-reported morbidities in this study included high blood pressure, high blood cholesterol, and diabetes. Air pollution data were obtained from the Thai government Pollution Control Department (PCD). Particles with diameters ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) exposures were estimated with ordinary kriging method using 22 background and 7 traffic monitoring stations in BMR during 2005-2013. Long-term exposure periods to air pollution for each subject was averaged as the same period of person-time. Cox proportional hazards models were used to examine the association between long-term air pollution exposure with self-reported high blood pressure, high blood cholesterol, diabetes. Results of self-reported morbidity were presented as hazard ratios (HRs) per interquartile range (IQR) increase in PM10, O3, NO2, SO2, and CO. RESULTS After controlling for potential confounders, we found that an IQR increase in PM10 was significantly associated with self-reported high blood pressure (HR = 1.13, 95% CI: 1.04, 1.23) and high blood cholesterol (HR = 1.07, 95%CI: 1.02, 1.12), but not with diabetes (HR = 1.05, 95%CI: 0.91, 1.21). SO2 was also positively associated with self-reported high blood pressure (HR = 1.22, 95%CI: 1.08, 1.38), high blood cholesterol (HR = 1.20, 95%CI: 1.11, 1.30), and diabetes (HR = 1.21, 95%CI: 0.92, 1.60). Moreover, we observed a positive association between CO and self-reported high blood pressure (HR = 1.07, 95%CI: 1.00, 1.15), but not for other diseases. However, self-reported morbidities were not associated with O3 and NO2. CONCLUSIONS Long-term exposure to air pollution, especially for PM10 and SO2 was associated with self-reported high blood pressure, high blood cholesterol, and diabetes in subjects of TCS. Our study supports that exposure to air pollution increases cardiovascular disease risk factors for younger population.
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Affiliation(s)
- Kanawat Paoin
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Kayo Ueda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan.
| | - Thammasin Ingviya
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Suhaimee Buya
- Medical Data Center for Research and Innovation, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Xerxes Tesoro Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Sam-Ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Adrian Sleigh
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Akiko Honda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
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Associations of household solid fuel for heating and cooking with hypertension in Chinese adults. J Hypertens 2020; 39:667-676. [PMID: 33186328 DOI: 10.1097/hjh.0000000000002689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The association between indoor air pollution resulting from household solid fuel use for heating and cooking with hypertension or blood pressure (BP) remains less clear. This study aims to rectify these knowledge gaps in a large Chinese population. METHODS During 2005-2009, 44 007 individuals aged 35-70 years with complete information on household solid fuel use for cooking and heating were recruited from 279 urban and rural communities of 12 centers. Solid fuel referred to charcoal, coal, wood, agriculture crop, animal dung or shrub. Annual concentration of ambient atmospheric particulate matter that have a diameter of less than 2.5 μm for all communities was collected. Generalized linear mixed models using community as the random effect were performed to estimate the association with hypertension prevalence or BP after considering ambient atmospheric particulate matter that have a diameter of less than 2.5 μm and a comprehensive set of potential confounding factors at the individual and household level. RESULTS A total of 47.6 and 61.2% of participants used household solid fuel for heating and cooking, respectively. Solid fuel use for heating was not associated with an increase in hypertension prevalence (adjusted odds ratio = 1.08, 95% confident interval: 0.98, 1.20) or elevated SBP (0.62 mmHg, 95% confident interval: -0.24, 1.48). No association was found between solid fuel for cooking and hypertension or BP, and no additional risk was observed among participants who had both exposures to solid fuel for heating and cooking compared with those used for heating only. CONCLUSION The current large Chinese study revealed a statistically insignificant increase in the association between solid fuel use for heating and hypertension prevalence or BP. As this cross-sectional study has its inherent limitation on causality, findings from this study would have to be confirmed by prospective cohort studies.
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Xu J, Zhang Y, Yao M, Wu G, Duan Z, Zhao X, Zhang J. 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. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 28:5991-6004. [PMID: 32978739 DOI: 10.1007/s11356-020-10893-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023]
Abstract
Hypertension, a major risk factor of many severe chronic diseases and leading cause of global disease burden, is reported to be associated with long-term exposure to PM2.5. China's high PM2.5 pollution level has become a major public health issue. However, existing studies from China have got inconsistent results with very limited investigation into the multi-ethnic peoples. This study adds multi-ethnic evidence from Sichuan Province, southwestern China, and assesses ethnic differences of PM2.5 exposure effect on hypertension. We pooled large cross-sectional data from two surveys conducted in 2013 and 2018 to examine the association of long-term exposure to PM2.5 on prevalence of hypertension in adults aged 30 years old and above. Community-specified annual PM2.5 concentration was estimated using satellite data. Thirty-one thousand four hundred sixty-two participants with average exposure concentration of 32.8 μg/m3 were included. The proportions of the Han, the Tibetan, the Yi, and other ethnic people were 89.2%, 7.3%, 3.2%, and 0.3%, respectively. The adjusted odds ratio (OR) was 1.08 (95% CI, 1.04-1.12) for a 10 μg/m3 PM2.5 concentration increment. The adjusted ORs for the Han, the Tibetan, and the Yi were 1.08 (95% CI, 1.04-1.12), 0.03 (95% CI, 0.00-0.27), and 1.75 (95% CI, 1.28-2.38) for a 10 μg/m3 PM2.5 concentration increment, respectively. Stratification analysis found stronger associations in participants with chronic diseases and Yi minority population. The results showed that long-term exposure to PM2.5 may increase the risk of hypertension prevalence in Chinese multi-ethnic adults. The associations were different among ethnicities.
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Affiliation(s)
- Jiayue Xu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yuqin Zhang
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Minghong Yao
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Gonghua Wu
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Zhanqi Duan
- Big Data Center of Sichuan Province, Chengdu, 610041, Sichuan, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Juying Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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29
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Kolpakova AF, Sharipov RN, Volkova OA, Kolpakov FA. Role of air pollution by particulate matter in the pathogenesis of cardiovascular diseases. Prevention measures. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The review highlights contemporary concepts about the role of atmospheric air pollution by particulate matter (PM) in pathogenesis of cardiovascular diseases (CVD). We used publications from the PubMed and Russian Science Citation Index databases. The influence of PM on the development and progression of CVD is considered depending on size, origin, chemical composition, concentration in air. PM with an aerodynamic diameter of ≤2,5 μm (PM2,5) are recognized as the most dangerous. Epidemiological studies have established a dose-dependent effect PM. Oxidative stress, damage of genome of cell and epigenetic changes associated with PM effect are the important component of CVD pathogenesis. Systematization of scientific data through a formalized description helps to understand the pathogenesis of CVD and facilitates its practical use for assessing the risk of occurrence, early diagnosing, prognostication, increasing the effectiveness of treatment, and developing preventive measures.
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Affiliation(s)
- A. F. Kolpakova
- Institute of Computational Technologies, Siberian Branch of the Russian Academy of Sciences
| | | | - O. A. Volkova
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences
| | - F. A. Kolpakov
- Institute of Computational Technologies, Siberian Branch of the Russian Academy of Sciences;
LLC BIOSOFT.RU
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Tong X, Ho JMW, Li Z, Lui KH, Kwok TCY, Tsoi KKF, Ho KF. Prediction model for air particulate matter levels in the households of elderly individuals in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 717:135323. [PMID: 31839290 DOI: 10.1016/j.scitotenv.2019.135323] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/14/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
Air pollution has shown to cause adverse health effects on mankind. Aging causes functional decline and leaves elderly people more susceptible to health threats associated with air pollution exposure. Elderly spend approximately 80% of their lifetime at home every day. To understand air pollution exposure, indoor air pollutants are the targets for consideration especially for the elderly population. However, indoor air monitoring for epidemiological studies requires a large population, is labor intensive and time consuming. As a result, a prediction model is necessary. For 3 consecutive days in summer and winter, 24-h average of mass concentrations of fine particulate matter (aerodynamic diameter <2.5 μm: PM2.5) were measured in indoors for 116 households. A PM2.5 prediction model for elderly households in Hong Kong has been developed by combining ambient PM2.5 concentrations obtained from land use regression model and questionnaire-elicited information related to the indoor PM2.5 sources. The fitted linear mixed-effects model is moderately predictive for the observed indoor PM2.5, with R2 = 0.67 (or R2 = 0.61 by cross-validation). The model shows indoor PM2.5 was positively influenced by outdoor PM2.5 levels. Meteorological factors (e.g. temperature and relative humidity) were related to the indoor PM2.5 in a relatively complex manner. Congested living areas, opening windows for extended periods for ventilation and use of liquefied petroleum gas for cooking were the factors determining the ultimate indoor air quality. This study aims to provide information about controlling household air quality and can be used for future epidemiological studies associated with indoor air pollution in large population.
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Affiliation(s)
- Xinning Tong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason Man Wai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhiyuan Li
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka-Hei Lui
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C Y Kwok
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelvin K F Tsoi
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - K F Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Chen CH, Wu CD, Chiang HC, Chu D, Lee KY, Lin WY, Yeh JI, Tsai KW, Guo YLL. The effects of fine and coarse particulate matter on lung function among the elderly. Sci Rep 2019; 9:14790. [PMID: 31616001 PMCID: PMC6794286 DOI: 10.1038/s41598-019-51307-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 09/27/2019] [Indexed: 01/09/2023] Open
Abstract
Impaired lung function is associated with morbidity and mortality in the elderly. However, there is a paucity of data regarding the long-term effects of particulate matter (PM) on lung function among the elderly. This study evaluated the exposure-response relationship between ambient PM and different lung function indices among the elderly in Taiwan. A cross-sectional survey of individuals aged ≥65 years was conducted in Taiwan from October 2015 to September 2016. Those who attended the annual health examination for the elderly in five hospitals of varying background PM concentrations were enrolled. The long-term (2015 annual mean concentration) exposure to air pollution was estimated by the Kriging method at the residence of each subject. The association between ambient PM exposure and lung function was evaluated by linear regression modeling, with adjustments for age, sex, height, weight, educational attainment, presence of asthma or chronic obstructive pulmonary disease, smoking status, season, and co-pollutants. There were 1241 subjects (mean age, 70.5 years). The mean residential PM2.5 and PM2.5–10 in 2015 was 26.02 and 18.01 μg/m3, respectively. After adjustments for confounders and co-pollutants, the FVC decrease was best associated with fine particles (PM2.5), whereas the FEV1, FEF25–75%, FEF25% and FEF50% decreases were best associated with coarse particles (PM2.5–10). An IQR (10 μg/m3) increase in PM2.5 decreased FVC by 106.38 ml (4.47%), while an IQR (7.29 μg/m3) increase in PM2.5–10 decreased FEV1 and FEF25–75% by 91.23 ml (4.85%) and 104.44 ml/s (5.58%), respectively. Among the Taiwanese elderly, long-term PM2.5 exposure mainly decreases the vital capacity of lung function. Moreover, PM2.5–10 has a stronger negative effect on the function of conductive airways than PM2.5.
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Affiliation(s)
- Chi-Hsien Chen
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of medicine and NTU Hospital, Taipei City, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan City, Taiwan
| | - Hung-Che Chiang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Dachen Chu
- School of Medicine, National Yang-Ming University, Taipei City, Taiwan.,Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei City, Taiwan.,Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.,Department of Neurosurgery, Taipei City Hospital, Taipei City, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Wen-Yi Lin
- Department of Occupational Medicine, Health Management Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Jih-I Yeh
- Department of Family Medicine, Hualien Tzu-Chi General Hospital, Hualien, Taiwan
| | - Kun-Wei Tsai
- Division of Geriatrics, Dalin Tzu-Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of medicine and NTU Hospital, Taipei City, Taiwan. .,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan. .,Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei City, Taiwan.
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Wang X, Zou Z, Dong B, Dong Y, Ma Y, Gao D, Yang Z, Wu S, Ma J. Association of School Residential PM 2.5 with Childhood High Blood Pressure: Results from an Observational Study in 6 Cities in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142515. [PMID: 31337125 PMCID: PMC6678215 DOI: 10.3390/ijerph16142515] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/04/2019] [Accepted: 07/12/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the association of long-term PM2.5 exposure with blood pressure (BP) outcomes in children aged 6-18 years, and to examine the population attributable risk (PAR) of PM2.5 exposure. METHODS A total of 53,289 participants aged 6-18 years with full record of age, sex, BP, height, and local PM2.5 exposure from a cross-sectional survey conducted in 6 cities of China in 2013 were involved in the present study. PM2.5 data from 18 January 2013 to 31 December 2013 were obtained from the nearest environmental monitoring station for each selected school. Two-level linear and logistic regression models were used to evaluate the influence of PM2.5 on children's BP, and PAR was calculated in each sex and age group. RESULTS Participants had a mean age of 10.8 (standard deviation: 3.4) years at enrollment, 51.7% of them were boys. U-shaped trends along with increased PM2.5 concentration were found for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the thresholds of 57.8 and 65.0 μg/m3, respectively. Both increased annual mean of PM2.5 concentration and ratio of polluted days were associated with increased BP levels and high blood pressure (HBP), with effect estimates for BP ranging from 2.80 (95% CI: -0.51, 6.11) mmHg to 5.78 (95% CI: 2.32, 9.25) mmHg for SBP and from 0.77 (95% CI: -1.98, 3.52) mmHg to 2.66 (-0.35, 5.66) mmHg for DBP, and the odds ratios for HBP from 1.21 (0.43, 3.38) to 1.92 (0.65, 5.67) in the highest vs. the lowest quartiles. Overall, 1.16% of HBP in our participants could be attributed to increased annual mean of PM2.5 concentration, while 2.82% could be attributed to increased ratio of polluted days. These proportions increased with age. CONCLUSIONS The association between long-term PM2.5 exposure and BP values appeared to be U-shaped in Chinese children aged 6-18 years, and increased PM2.5 exposure was associated with higher risk of HBP.
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Affiliation(s)
- Xijie Wang
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China.
- Key laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China.
| | - Bin Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Di Gao
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Shaowei Wu
- School of Public Health, Peking University, Beijing 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, Beijing 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University Health Science Center, Beijing 100191, China.
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Li N, Chen G, Liu F, Mao S, Liu Y, Hou Y, Lu Y, Liu S, Wang C, Xiang H, Guo Y, Li S. Associations of long-term exposure to ambient PM 1 with hypertension and blood pressure in rural Chinese population: The Henan rural cohort study. ENVIRONMENT INTERNATIONAL 2019; 128:95-102. [PMID: 31035115 PMCID: PMC7086153 DOI: 10.1016/j.envint.2019.04.037] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND The epidemiological evidence on relationships between long-term exposure to particulate matter and hypertension and blood pressure has been inconclusive. Limited evidence was available for particulate matter with an aerodynamic diameter ≤ 1 μm (PM1) in rural areas of developing countries. OBJECTIVE This study aimed to investigate the associations between long-term exposure to PM1 and hypertension and blood pressure among rural Chinese population. METHODS This study included 39,259 participants who had completed the baseline survey from Henan Rural Cohort. Participants' exposure to PM1 was assessed by a satellite-based spatiotemporal model. The binary logistic regression model was used to examine the association between long-term PM1 exposure and hypertension, and multivariable linear regression model was used to investigate the associations between long-term PM1 exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Moreover, we examined potential effect modifications by demographic, lifestyle and diet factors. RESULTS The mean concentration of PM1 for all participants during the 3-year before baseline survey was 59.98 μg/m3. Each 1 μg/m3 increase in PM1 concentration was significantly associated with an increase of 4.3% [Odds ratio(OR) = 1.043, 95% confidence interval(CI): 1.033, 1.053] in odds for hypertension, an increase of 0.401 mm Hg (95% CI, 0.335, 0.467), 0.328 mm Hg (95% CI, 0.288, 0.369), 0.353 mm Hg (95% CI, 0.307, 0.399) and 0.073 mm Hg (95% CI, 0.030, 0.116) in SBP, DBP, MAP and PP, respectively. Further stratified analyses showed that the effect of PM1 on hypertension and blood pressure could be modified by sex, lifestyle and diet. CONCLUSIONS This study suggests that long-term exposure to ambient PM1 increases the risk of hypertension and is associated with elevations in blood pressure in rural Chinese adults, especially in male and those with unhealthy habits.
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Affiliation(s)
- Na Li
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Feifei Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Shuyuan Mao
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, 1959 NE Pacific Street, Seattle, USA
| | - Yitan Hou
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, 1960 East West Rd, Biomed Bldg, D105, Honolulu, USA
| | - Suyang Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Curto A, Wellenius GA, Milà C, Sanchez M, Ranzani O, Marshall JD, Kulkarni B, Bhogadi S, Kinra S, Tonne C. Ambient Particulate Air Pollution and Blood Pressure in Peri-urban India. Epidemiology 2019; 30:492-500. [PMID: 31162282 PMCID: PMC6558270 DOI: 10.1097/ede.0000000000001014] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Evidence linking long-term exposure to particulate air pollution to blood pressure (BP) in high-income countries may not be transportable to low- and middle-income countries. We examined cross-sectional associations between ambient fine particulate matter (PM2.5) and black carbon (BC) with BP (systolic [SBP] and diastolic [DBP]) and prevalent hypertension in adults from 28 peri-urban villages near Hyderabad, India. METHODS We studied 5531 participants from the Andhra Pradesh Children and Parents Study (18-84 years, 54% men). We measured BP (2010-2012) in the right arm and defined hypertension as SBP ≥130 mmHg and/or DBP ≥80 mmHg. We used land-use regression models to estimate annual average PM2.5 and BC at participant's residence. We applied linear and logistic nested mixed-effect models stratified by sex and adjusted by cooking fuel type to estimate associations between within-village PM2.5 or BC and health. RESULTS Mean (SD) PM2.5 was 33 µg/m (2.7) and BC was 2.5 µg/m (0.23). In women, a 1 µg/m increase in PM2.5 was associated with 1.4 mmHg higher SBP (95% confidence interval [CI]: 0.12, 2.7), 0.87 mmHg higher DBP (95% CI: -0.18, 1.9), and 4% higher odds of hypertension (95% CI: 0%, 9%). In men, associations with SBP (0.52 mmHg; 95% CI: -0.82, 1.8), DBP (0.41 mmHg; 95% CI: -0.69, 1.5), and hypertension (2% higher odds; 95% CI: -2%, 6%) were weaker. No associations were observed with BC. CONCLUSION We observed a positive association between ambient PM2.5 and BP and hypertension in women. Longitudinal studies in this region are needed to corroborate our findings.
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Affiliation(s)
- Ariadna Curto
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y
Salud Pública, Barcelona, Spain
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public
Health, RI, USA
| | - Carles Milà
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y
Salud Pública, Barcelona, Spain
| | - Margaux Sanchez
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y
Salud Pública, Barcelona, Spain
| | - Otavio Ranzani
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y
Salud Pública, Barcelona, Spain
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of
Washington, WA, USA
| | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research,
Hyderabad, India
| | - Santhi Bhogadi
- Public Health Foundation of India, Indian Institute for Public
Health, Hyderabad, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School
of Hygiene and Tropical Medicine, London, UK
| | - Cathryn Tonne
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y
Salud Pública, Barcelona, Spain
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Avila-Palencia I, Laeremans M, Hoffmann B, Anaya-Boig E, Carrasco-Turigas G, Cole-Hunter T, de Nazelle A, Dons E, Götschi T, Int Panis L, Orjuela JP, Standaert A, Nieuwenhuijsen MJ. Effects of physical activity and air pollution on blood pressure. ENVIRONMENTAL RESEARCH 2019; 173:387-396. [PMID: 30954912 DOI: 10.1016/j.envres.2019.03.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 06/09/2023]
Abstract
AIM To assess the main and interaction effects of black carbon and physical activity on arterial blood pressure in a healthy adult population from three European cities using objective personal measurements over short-term (hours and days) and long-term exposure. METHODS A panel study of 122 healthy adults was performed in three European cities (Antwerp, Barcelona, and London). In 3 seasons between March 2015 and March 2016, each participant wore sensors for one week to objectively measure their exposure to black carbon and monitor their physical activity continuously. Blood pressure was assessed three times during the week: at the beginning (day 0), in the middle (day 4), and at the end (day 7). Associations of black carbon and physical activity with blood pressure and their interactions were investigated with linear regression models and multiplicative interaction terms, adjusting for all the potential confounders. RESULTS In multiple exposure models, we did not see any effects of black carbon on blood pressure but did see effects on systolic blood pressure of moderate-to-vigorous physical activity effect that were statistically significant from 1 h to 8 h after exposure and for long-term exposure. For a 1METhour increase of moderate-to-vigorous physical activity, the difference in the expected mean systolic blood pressure varied from -1.46 mmHg (95%CI -2.11, -0.80) for 1 h mean exposure, to -0.29 mmHg (95%CI -0.55, -0.03) for 8 h mean exposure, and -0.05 mmHg (95%CI -0.09, -0.00) for long-term exposure. There were little to no interaction effects. CONCLUSIONS Results from this study provide evidence that short-term and long-term exposure to moderate-to-vigorous physical activity is associated with a decrease in systolic blood pressure levels. We did not find evidence for a consistent main effect of black carbon on blood pressure, nor any interaction between black carbon and physical activity levels.
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Affiliation(s)
- Ione Avila-Palencia
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Michelle Laeremans
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Germany
| | | | - Glòria Carrasco-Turigas
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tom Cole-Hunter
- Centre for Air Pollution, Energy and Health Research (CAR), Sydney, Australia; International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, School of Chemistry, Physics and Mechanical Engineering, Faculty of Science and Engineering, Queensland University of Technology (QUT), Brisbane, Australia
| | | | - Evi Dons
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | - Thomas Götschi
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
| | - Luc Int Panis
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Hasselt University, Hasselt, Belgium
| | | | - Arnout Standaert
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Mark J Nieuwenhuijsen
- ISGlobal. Barcelona, Spain; Universitat Pompeu Fabra (UPF). Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
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36
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Adar SD, Chen YH, D'Souza JC, O'Neill MS, Szpiro AA, Auchincloss AH, Park SK, Daviglus ML, Diez Roux AV, Kaufman JD. Longitudinal Analysis of Long-Term Air Pollution Levels and Blood Pressure: A Cautionary Tale from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:107003. [PMID: 30392401 PMCID: PMC6371645 DOI: 10.1289/ehp2966] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Air pollution exposures are hypothesized to impact blood pressure, yet few longitudinal studies exist, their findings are inconsistent, and different adjustments have been made for potentially distinct confounding by calendar time and age. OBJECTIVE We aimed to investigate the associations of long- and short-term [Formula: see text] and [Formula: see text] concentrations with systolic and diastolic blood pressures and incident hypertension while also accounting for potential confounding by age and time. METHODS Between 2000 and 2012, Multi-Ethnic Study of Atherosclerosis participants were measured for systolic and diastolic blood pressure at five exams. We estimated annual average and daily [Formula: see text] and [Formula: see text] concentrations for 6,569 participants using spatiotemporal models and measurements, respectively. Associations of exposures with blood pressure corrected for medication were studied using mixed-effects models. Incident hypertension was examined with Cox regression. We adjusted all models for sex, race/ethnicity, socioeconomic status, smoking, physical activity, diet, season, and site. We compared associations from models adjusting for time-varying age with those that adjusted for both time-varying age and calendar time. RESULTS We observed decreases in pollution and blood pressures (adjusted for age and medication) over time. Strong, positive associations of long- and short-term exposures with blood pressure were found only in models with adjustment for time-varying age but not adjustment for both time-varying age and calendar time. For example, [Formula: see text] higher annual average [Formula: see text] concentrations were associated with 2.7 (95% CI: 1.5, 4.0) and [Formula: see text] (95% CI: [Formula: see text] 1.0) mmHg in systolic blood pressure with and without additional adjustment for time, respectively. Associations with incident hypertension were similarly weakened by additional adjustment for time. Sensitivity analyses indicated that air pollution did not likely cause the temporal trends in blood pressure. CONCLUSIONS In contrast to experimental evidence, we found no associations between long- or short-term exposures to air pollution and blood pressure after accounting for both time-varying age and calendar time. This research suggests that careful consideration of both age and time is needed in longitudinal studies with trending exposures. https://doi.org/10.1289/EHP2966.
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Affiliation(s)
- Sara D Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Yeh-Hsin Chen
- Harris County Public and Environmental Services, Houston, Texas, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jennifer C D'Souza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Marie S O'Neill
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Martha L Daviglus
- Institute of Minority Health Research, University of Illinois College of Medicine, Chicago, Illinois, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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37
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Xie X, Wang Y, Yang Y, Xu J, Zhang Y, Tang W, Guo T, Wang Q, Shen H, Zhang Y, Yan D, Peng Z, Chen Y, He Y, Ma X. Long-Term Effects of Ambient Particulate Matter (With an Aerodynamic Diameter ≤2.5 μm) on Hypertension and Blood Pressure and Attributable Risk Among Reproductive-Age Adults in China. J Am Heart Assoc 2018; 7:JAHA.118.008553. [PMID: 29700042 PMCID: PMC6015291 DOI: 10.1161/jaha.118.008553] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Epidemiological evidence on the association between long‐term exposure to ambient fine particulate matter (with an aerodynamic diameter ≤2.5 μm; PM2.5) and hypertension is mixed. We investigated the long‐term association between ambient fine particles and hypertension in reproductive‐age adults. Methods and Results This analysis included 39 348 119 reproductive‐age (20–49 years) participants from the National Free Preconception Health Examination Project from April 22, 2010 to December 31, 2015 across China. The estimation of annual average ambient PM2.5 concentrations for each community was realized through using satellite‐based spatial statistical models. Linear mixed models and 2‐level logistic regressions adjusted for potential confounders with natural cubic splines were used to investigate the shape of PM2.5–blood pressure and PM2.5‐hypertension, respectively. The effect modification by sex, obesity, smoking status, age, diabetes mellitus, urbanity, race, and region was also taken into account. The concentration‐response relationship between PM2.5 and hypertension was nonlinear, with a threshold concentration of 47.9 μg/m3. The odds ratio of hypertension related to a 10‐μg/m3 increase in PM2.5 above threshold was 1.010 (95% confidence interval, 1.007–1.012). A 10‐μg/m3 increase in PM2.5 above threshold corresponded to a 0.569 (95% confidence interval, 0.564–0.573) mm Hg elevation in systolic blood pressure and a 0.384 (95% confidence interval, 0.381–0.388) mm Hg elevation in diastolic blood pressure. There were 2.3% (95% confidence interval, 2.2%–2.4%) of the hypertension cases that could be attributed to PM2.5 exposures in reproductive‐age adult populations. Conclusions Long‐term exposures to PM2.5 above certain levels might increase population risk for hypertension and might be responsible for China's avoidable hypertension burden in reproductive‐age adults.
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Affiliation(s)
- Xiaoxu Xie
- National Research Institute for Health and Family Planning, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Yuanyuan Wang
- National Research Institute for Health and Family Planning, Beijing, China
| | - Ying Yang
- National Research Institute for Health and Family Planning, Beijing, China
| | - Jihong Xu
- National Research Institute for Health and Family Planning, Beijing, China
| | - Ya Zhang
- National Research Institute for Health and Family Planning, Beijing, China
| | - Wenbin Tang
- National Research Institute for Health and Family Planning, Beijing, China
| | - Tongjun Guo
- National Research Institute for Health and Family Planning, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Health and Family Planning, Beijing, China
| | - Yixin Chen
- Graduate School of Peking Union Medical College, Beijing, China.,Department of Computer Science and Engineering, Washington University, St Louis, MO
| | - Yuan He
- National Research Institute for Health and Family Planning, Beijing, China .,Graduate School of Peking Union Medical College, Beijing, China.,Research Center for Population Health and Risk Assessment, National Human Genetic Resources Center, Beijing, China
| | - Xu Ma
- National Research Institute for Health and Family Planning, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China.,Research Center for Population Health and Risk Assessment, National Human Genetic Resources Center, Beijing, China
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38
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Yang BY, Qian Z, Howard SW, Vaughn MG, Fan SJ, Liu KK, Dong GH. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 235:576-588. [PMID: 29331891 DOI: 10.1016/j.envpol.2018.01.001] [Citation(s) in RCA: 317] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/07/2017] [Accepted: 01/01/2018] [Indexed: 05/21/2023]
Abstract
Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter<2.5 μm (PM2.5), 2.5-10 μm (PM2.5-10) or >10 μm (PM10)) and gaseous (sulfur dioxide (SO2), nitrogen dioxide (NO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM2.5 with hypertension (OR = 1.05), and of PM10, PM2.5, and NO2 with DBP (β values: 0.47-0.86 mmHg). In addition, short-term exposures to four (PM10, PM2.5, SO2, NO2), two (PM2.5 and SO2), and four air pollutants (PM10, PM2.5, SO2, and NO2), were significantly associated with hypertension (ORs: 1.05-1.10), SBP (β values: 0.53-0.75 mmHg) and DBP (β values: 0.15-0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Steven W Howard
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Shu-Jun Fan
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Kang-Kang Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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39
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Chen SY, Chu DC, Lee JH, Yang YR, Chan CC. Traffic-related air pollution associated with chronic kidney disease among elderly residents in Taipei City. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 234:838-845. [PMID: 29248851 DOI: 10.1016/j.envpol.2017.11.084] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 11/08/2017] [Accepted: 11/26/2017] [Indexed: 06/07/2023]
Abstract
The associations of air pollution with chronic kidney disease (CKD) have not yet been fully studied. We enrolled 8,497 Taipei City residents older than 65 years and calculated the estimated glomerular filtration rate (eGFR) using the Taiwanese Chronic Kidney Disease Epidemiology Collaboration equation. Proteinuria was assessed via dipstick on voided urine. CKD prevalence and risk of progression were defined according to the KDIGO 2012 guidelines. Land-use regression models were used to estimate the participants' one-year exposures to PM of different sizes and traffic-related exhaust, PM2.5 absorbance, nitrogen dioxide (NO2), and NOx. Generalized linear regressions and logistic regressions were used to examine the associations of one-year air pollution exposures with eGFR, proteinuria, CKD prevalence and risk of progression. The results showed that the interquartile range (IQR) increments of PM2.5 absorbance (0.4 × 10-5/m) and NO2 (7.0 μg/m3) were associated with a 1.07% [95% confidence interval (CI): 0.54-1.57] and 0.84% (95% CI: 0.37-1.32) lower eGFR, respectively; such relationships were magnified in subjects who had an eGFR >60 ml/min/1.73 m2 or who were non-diabetic. Similar associations were also observed for PM10 and PM2.5-10. Two-pollutant models showed that PM10 and PM2.5 absorbance were associated with a lower eGFR. The odd ratios (ORs) of CKD prevalence and risk of progression also increased with exposures to PM2.5 absorbance and NO2. In summary, one-year exposures to traffic-related air pollution were associated with lower eGFR, higher CKD prevalence, and increased risk of CKD progression among the elderly population. Air pollution-related impaired renal function was stronger in non-CKD and non-diabetic subjects.
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Affiliation(s)
- Szu-Ying Chen
- Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Da-Chen Chu
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
| | - Jui-Huan Lee
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ya-Ru Yang
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.
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40
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Abstract
PURPOSE OF REVIEW Worldwide demographic changes occurring in a relatively short period have led to a growing interest in the determinants of aging "successfully" and how to promote a healthier old age. As environmental exposures such as ambient air pollution are believed to play a role in the process of aging, they might represent one of the pathways turning potential successful agers to unsuccessful agers. We aimed to critically review the current epidemiological evidence of the associations between chronic exposure to ambient air pollution and several key determinants of unsuccessful aging and to identify specific populations of unsuccessful agers that are potentially more vulnerable to air pollution's health effects. RECENT FINDINGS Epidemiologic evidence supports the association between air pollution and increased risk for several major chronic diseases, cognitive impairment, frailty, and decreased longevity-all important determinants of unsuccessful aging-as well as evidence for higher vulnerability among frail populations. However, several methodological shortcomings, including possible publication bias, lack of use of an adequate indicator of unsuccessful aging, limitations in exposure assessment, and residual confounding particularly due to socioeconomic status, hinder inference of causal relationship at this stage. Future studies should use constructs such as frailty index to estimate successful aging, as well as integrate time activity patterns into the exposure assessment metric. Additionally, studies in low- and middle-income countries are needed.
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Liu H, Zhang X, Zhang H, Yao X, Zhou M, Wang J, He Z, Zhang H, Lou L, Mao W, Zheng P, Hu B. Effect of air pollution on the total bacteria and pathogenic bacteria in different sizes of particulate matter. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 233:483-493. [PMID: 29101891 DOI: 10.1016/j.envpol.2017.10.070] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 05/21/2023]
Abstract
In recent years, air pollution events have occurred frequently in China during the winter. Most studies have focused on the physical and chemical composition of polluted air. Some studies have examined the bacterial bioaerosols both indoors and outdoors. But few studies have focused on the relationship between air pollution and bacteria, especially pathogenic bacteria. Airborne PM samples with different diameters and different air quality index values were collected in Hangzhou, China from December 2014 to January 2015. High-throughput sequencing of 16S rRNA was used to categorize the airborne bacteria. Based on the NCBI database, the "Human Pathogen Database" was established, which is related to human health. Among all the PM samples, the diversity and concentration of total bacteria were lowest in the moderately or heavily polluted air. However, in the PM2.5 and PM10 samples, the relative abundances of pathogenic bacteria were highest in the heavily and moderately polluted air respectively. Considering the PM samples with different particle sizes, the diversities of total bacteria and the proportion of pathogenic bacteria in the PM10 samples were different from those in the PM2.5 and TSP samples. The composition of PM samples with different sizes range may be responsible for the variances. The relative humidity, carbon monoxide and ozone concentrations were the main factors, which affected the diversity of total bacteria and the proportion of pathogenic bacteria. Among the different environmental samples, the compositions of the total bacteria were very similar in all the airborne PM samples, but different from those in the water, surface soil, and ground dust samples. Which may be attributed to that the long-distance transport of the airflow may influence the composition of the airborne bacteria. This study of the pathogenic bacteria in airborne PM samples can provide a reference for environmental and public health researchers.
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Affiliation(s)
- Huan Liu
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Xu Zhang
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Hao Zhang
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Xiangwu Yao
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Meng Zhou
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Jiaqi Wang
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Zhanfei He
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Huihui Zhang
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Liping Lou
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Weihua Mao
- The Center of Analysis and Measurement, Zhejiang University, Hangzhou, 310058, China
| | - Ping Zheng
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China
| | - Baolan Hu
- Department of Environmental Engineering, Zhejiang University, Hangzhou, 310058, China; Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, 310058, China.
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Zhang Z, Guo C, Lau AKH, Chan TC, Chuang YC, Lin C, Jiang WK, Yeoh EK, Tam T, Woo KS, Yan BP, Chang LY, Wong MCS, Lao XQ. Long-Term Exposure to Fine Particulate Matter, Blood Pressure, and Incident Hypertension in Taiwanese Adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:017008. [PMID: 29351544 PMCID: PMC6014706 DOI: 10.1289/ehp2466] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Long-term exposure to particulate matter (PM) air pollution may increase blood pressure and the risk of hypertension. However, epidemiological evidence is scarce and inconsistent. OBJECTIVES We investigated the associations between long-term exposure to PM with an aerodynamic diameter <2.5μm (PM2.5), blood pressure, and incident hypertension in a large Taiwanese cohort. METHODS We studied 361,560 adults ≥18y old from a large cohort who participated in a standard medical examination program during 2001 to 2014. Among this group, 125,913 nonhypertensive participants were followed up. A satellite-based spatiotemporal model was used to estimate the 2-y average PM2.5 concentrations at each participant's address. Multivariable linear regression was used in the cross-sectional data analysis with the 361,560 participants to investigate the associations between PM2.5 and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), and Cox proportional hazard regression was used in the cohort data analysis with the 125,913 participants to investigate the associations between PM2.5 and incident hypertension. RESULTS Each 10-μg/m3 increment in the 2-y average PM2.5 concentration was associated with increases of 0.45 mmHg [95% confidence interval (CI): 0.40, 0.50], 0.07 mmHg (95% CI: 0.04, 0.11), and 0.38 mmHg (95% CI: 0.33, 0.42) in SBP, DBP, and PP, respectively, after adjusting for a wide range of covariates and possible confounders. Each 10-μg/m3 increment in the 2-y average PM2.5 concentration was associated with an increase of 3% in the risk of developing hypertension [hazard ratio=1.03 (95% CI: 1.01, 1.05)]. Stratified and sensitivity analyses yielded similar results. CONCLUSIONS Long-term exposure to PM2.5 air pollution is associated with higher blood pressure and an increased risk of hypertension. These findings reinforce the importance of air pollution mitigation strategies to reduce the risk of cardiovascular disease. https://doi.org/10.1289/EHP2466.
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Affiliation(s)
- Zilong Zhang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alexis K H Lau
- Department of Civil and Environmental Engineering, Hong Kong University of Science and Technology, Hong Kong SAR, China
- Division of Environment and Sustainability, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
| | | | - Changqing Lin
- Department of Civil and Environmental Engineering, Hong Kong University of Science and Technology, Hong Kong SAR, China
- Division of Environment and Sustainability, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Eng-Kiong Yeoh
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kam S Woo
- Institute of Future Cities, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bryan P Yan
- Department of Medicine & Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- MJ Health Research Foundation, MJ Group, Taiwan
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute of Chinese University of Hong Kong, Shenzhen, China
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43
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Fuks KB, Weinmayr G, Basagaña X, Gruzieva O, Hampel R, Oftedal B, Sørensen M, Wolf K, Aamodt G, Aasvang GM, Aguilera I, Becker T, Beelen R, Brunekreef B, Caracciolo B, Cyrys J, Elosua R, Eriksen KT, Foraster M, Fratiglioni L, Hilding A, Houthuijs D, Korek M, Künzli N, Marrugat J, Nieuwenhuijsen M, Östenson CG, Penell J, Pershagen G, Raaschou-Nielsen O, Swart WJR, Peters A, Hoffmann B. Long-term exposure to ambient air pollution and traffic noise and incident hypertension in seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). Eur Heart J 2017; 38:983-990. [PMID: 28417138 DOI: 10.1093/eurheartj/ehw413] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/11/2016] [Indexed: 12/28/2022] Open
Abstract
Aims We investigated whether traffic-related air pollution and noise are associated with incident hypertension in European cohorts. Methods and results We included seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). We modelled concentrations of particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), ≤10 µm (PM10), >2.5, and ≤10 µm (PMcoarse), soot (PM2.5 absorbance), and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled at the facade according to the EU Directive 2002/49/EC. We assessed hypertension as (i) self-reported and (ii) measured (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or intake of BP lowering medication (BPLM). We used Poisson regression with robust variance estimation to analyse associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders, and combined the results from individual studies with random-effects meta-analysis. Among 41 072 participants free of self-reported hypertension at baseline, 6207 (15.1%) incident cases occurred within 5-9 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 (relative risk (RR) 1.22 [95%-confidence interval (CI):1.08; 1.37] per 5 µg/m³) and PM2.5 absorbance (RR 1.13 [95% CI:1.02; 1.24] per 10 - 5m - 1). These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 10 896 participants at risk, 3549 new cases of measured hypertension occurred. We found no clear associations with measured hypertension. Conclusion Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension.
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Affiliation(s)
- Kateryna B Fuks
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich-Heine-University of Düsseldorf, University Hospital of Düsseldorf, AG Umweltepidemiologie, P.O. Box 101007, 40001 Düsseldorf, Germany
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, D 89081 Ulm, Germany
| | - Xavier Basagaña
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL). C/ Doctor Aiguader 88, 08003 Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Olena Gruzieva
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Regina Hampel
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Bente Oftedal
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Mette Sørensen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Kathrin Wolf
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Geir Aamodt
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Gunn Marit Aasvang
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Inmaculada Aguilera
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Thomas Becker
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Rob Beelen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80.178, NL-3508 TD Utrecht, the Netherlands
| | - Bert Brunekreef
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80.178, NL-3508 TD Utrecht, the Netherlands.,Julius Center for Primary Care and Health Sciences, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, the Netherlands
| | - Barbara Caracciolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.,Stockholm University, Universitetsvägen 10, 114 18 Stockholm, Sweden
| | - Josef Cyrys
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.,Environmental Science Center, the University of Augsburg, Universitätsstraße 1a, 86159 Augsburg, Germany
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Kirsten Thorup Eriksen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Maria Foraster
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.,Stockholm University, Universitetsvägen 10, 114 18 Stockholm, Sweden.,Stockholm Gerontology Research Center, Gävlegatan 16, 8 trappor, 113 30 Stockholm, Sweden
| | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Michal Korek
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Jaume Marrugat
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL). C/ Doctor Aiguader 88, 08003 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain.,Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
| | - Johanna Penell
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Göran Pershagen
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Ole Raaschou-Nielsen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Wim J R Swart
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Annette Peters
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.,Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislaufforschung e.V. (partner-site Munich), Biedersteiner Strasse 29, 80802 Munich, Germany
| | - Barbara Hoffmann
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich-Heine-University of Düsseldorf, University Hospital of Düsseldorf, AG Umweltepidemiologie, P.O. Box 101007, 40001 Düsseldorf, Germany
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Pitchika A, Hampel R, Wolf K, Kraus U, Cyrys J, Babisch W, Peters A, Schneider A. Long-term associations of modeled and self-reported measures of exposure to air pollution and noise at residence on prevalent hypertension and blood pressure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 593-594:337-346. [PMID: 28346907 DOI: 10.1016/j.scitotenv.2017.03.156] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 03/13/2017] [Accepted: 03/17/2017] [Indexed: 05/25/2023]
Abstract
Air pollution, traffic noise and noise annoyance are suggested to be associated with hypertension and blood pressure (BP); however, the evidence remains inconsistent. Our study examined the long-term associations of modeled and self-reported measures of air pollution and traffic noise on prevalent hypertension and BP. We analyzed cross-sectional data from 2552 participants aged 31-72years from the KORA F4 (2006-2008) study conducted in the region of Augsburg, Germany. Land-use regression models were used to estimate residential long-term exposure to particulate matter <2.5μm (PM2.5), soot content of PM2.5 (PM2.5abs) and nitrogen dioxide (NO2). Road traffic noise levels at the facade of the dwellings were estimated for the participants' residences. Participants filled-in a questionnaire on noise annoyance and heavy traffic passing their residence. Linear and logistic regression models adjusting for confounders were used to assess the association between exposure measures and hypertension and BP. An interquartile increase in annual mean PM2.5 (1μg/m3) was significantly associated with 15% higher prevalence of hypertension, without (95% CI: 2.5; 28.0%) and with (95% CI: 0.7; 30.8%) adjustment for traffic noise. Diastolic blood pressure (DBP) was associated with air pollutants and traffic noise with percent increases in mean of 0.7 (95% CI: 0.2; 1.2), 0.6 (95% CI: 0.1; 1.1) and 0.3 (95% CI: 0.0; 0.7) for an interquartile increase in PM2.5 (1μg/m3) and PM2.5abs (0.2∗10-5/m), and 5dB(A) increase in 24-hour road traffic noise, respectively. Associations of PM2.5abs and NO2 with hypertension or DBP were stronger in men and diabetic individuals. No clear associations were seen with systolic BP or noise annoyance. In conclusion, self-reported measures of air pollution or noise did not perform better than the objective measures. Our findings provide further evidence for a link between air pollution, noise and cardiovascular disease and indicate a stronger association for men and diabetic individuals.
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Affiliation(s)
- Anitha Pitchika
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Informatics, Biometry und Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - Regina Hampel
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Kathrin Wolf
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Ute Kraus
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Josef Cyrys
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany; ESC - Environmental Center, University of Augsburg, Augsburg, Germany
| | - Wolfgang Babisch
- Department of Environmental Hygiene, Federal Environment Agency, Berlin, Germany
| | - Annette Peters
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; DZHK-German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Germany
| | - Alexandra Schneider
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany.
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Honda T, Eliot MN, Eaton CB, Whitsel E, Stewart JD, Mu L, Suh H, Szpiro A, Kaufman JD, Vedal S, Wellenius GA. Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women. ENVIRONMENT INTERNATIONAL 2017; 105:79-85. [PMID: 28521192 PMCID: PMC5532534 DOI: 10.1016/j.envint.2017.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/10/2017] [Accepted: 05/10/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Long-term exposure to ambient particulate matter (PM) has been previously linked with higher risk of cardiovascular events. This association may be mediated, at least partly, by increasing the risk of incident hypertension, a key determinant of cardiovascular risk. However, whether long-term exposure to PM is associated with incident hypertension remains unclear. METHODS Using national geostatistical models incorporating geographic covariates and spatial smoothing, we estimated annual average concentrations of residential fine (PM2.5), respirable (PM10), and course (PM10-2.5) fractions of particulate matter among 44,255 post-menopausal women free of hypertension enrolled in the Women's Health Initiative (WHI) clinical trials. We used time-varying Cox proportional hazards models to evaluate the association between long-term average residential pollutant concentrations and incident hypertension, adjusting for potential confounding by sociodemographic factors, medical history, neighborhood socioeconomic measures, WHI study clinical site, clinical trial, and randomization arm. RESULTS During 298,383 person-years of follow-up, 14,511 participants developed incident hypertension. The adjusted hazard ratios per interquartile range (IQR) increase in PM2.5, PM10, and PM10-2.5 were 1.13 (95% CI: 1.08, 1.17), 1.06 (1.03, 1.10), and 1.01 (95% CI: 0.97, 1.04), respectively. Statistically significant concentration-response relationships were identified for PM2.5 and PM10 fractions. The association between PM2.5 and hypertension was more pronounced among non-white participants and those residing in the Northeastern United States. CONCLUSIONS In this cohort of post-menopausal women, ambient fine and respirable particulate matter exposures were associated with higher incidence rates of hypertension. These results suggest that particulate matter may be an important modifiable risk factor for hypertension.
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Affiliation(s)
- Trenton Honda
- Department of Health Sciences, Northeastern University, Boston, MA, United States.
| | - Melissa N Eliot
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | - Charles B Eaton
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States; Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, United States
| | - Eric Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States; Department of Medicine, School of Medicine, University of North Carolina Chapel Hill, NC, United States
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Lina Mu
- School of Public Health and Health Professions, State University of New York, Buffalo, Buffalo, NY, United States
| | - Helen Suh
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA, United States
| | - Adam Szpiro
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Joel D Kaufman
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Sverre Vedal
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Gregory A Wellenius
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
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46
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Honda T, Eliot MN, Eaton CB, Whitsel E, Stewart JD, Mu L, Suh H, Szpiro A, Kaufman JD, Vedal S, Wellenius GA. Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women. ENVIRONMENT INTERNATIONAL 2017. [PMID: 28521192 DOI: 10.1016/j.envint.2017.05.009%5bpublished] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Long-term exposure to ambient particulate matter (PM) has been previously linked with higher risk of cardiovascular events. This association may be mediated, at least partly, by increasing the risk of incident hypertension, a key determinant of cardiovascular risk. However, whether long-term exposure to PM is associated with incident hypertension remains unclear. METHODS Using national geostatistical models incorporating geographic covariates and spatial smoothing, we estimated annual average concentrations of residential fine (PM2.5), respirable (PM10), and course (PM10-2.5) fractions of particulate matter among 44,255 post-menopausal women free of hypertension enrolled in the Women's Health Initiative (WHI) clinical trials. We used time-varying Cox proportional hazards models to evaluate the association between long-term average residential pollutant concentrations and incident hypertension, adjusting for potential confounding by sociodemographic factors, medical history, neighborhood socioeconomic measures, WHI study clinical site, clinical trial, and randomization arm. RESULTS During 298,383 person-years of follow-up, 14,511 participants developed incident hypertension. The adjusted hazard ratios per interquartile range (IQR) increase in PM2.5, PM10, and PM10-2.5 were 1.13 (95% CI: 1.08, 1.17), 1.06 (1.03, 1.10), and 1.01 (95% CI: 0.97, 1.04), respectively. Statistically significant concentration-response relationships were identified for PM2.5 and PM10 fractions. The association between PM2.5 and hypertension was more pronounced among non-white participants and those residing in the Northeastern United States. CONCLUSIONS In this cohort of post-menopausal women, ambient fine and respirable particulate matter exposures were associated with higher incidence rates of hypertension. These results suggest that particulate matter may be an important modifiable risk factor for hypertension.
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Affiliation(s)
- Trenton Honda
- Department of Health Sciences, Northeastern University, Boston, MA, United States.
| | - Melissa N Eliot
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | - Charles B Eaton
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States; Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, United States
| | - Eric Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States; Department of Medicine, School of Medicine, University of North Carolina Chapel Hill, NC, United States
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Lina Mu
- School of Public Health and Health Professions, State University of New York, Buffalo, Buffalo, NY, United States
| | - Helen Suh
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA, United States
| | - Adam Szpiro
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Joel D Kaufman
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Sverre Vedal
- School of Public Health, University of Washington, Seattle, WA, United States
| | - Gregory A Wellenius
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
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Liu C, Chen R, Zhao Y, Ma Z, Bi J, Liu Y, Meng X, Wang Y, Chen X, Li W, Kan H. Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 584-585:869-874. [PMID: 28153400 PMCID: PMC8102884 DOI: 10.1016/j.scitotenv.2017.01.133] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/11/2017] [Accepted: 01/20/2017] [Indexed: 05/17/2023]
Abstract
Limited evidence is available regarding the long-term effects of fine particulate (PM2.5) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM2.5 with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM2.5 for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM2.5 and hypertension prevalence and linear regression models for the associations between PM2.5 and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM2.5 for all participants was 72.8μg/m3 on average. An interquartile range increase (IQR, 41.7μg/m3) in PM2.5 was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM2.5. The effects of PM2.5 on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM2.5 was associated with increased prevalence of hypertension and slightly higher systolic BP in China.
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Affiliation(s)
- Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Lab of Meteorology and Health, Shanghai, China
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Yafeng Wang
- Institute for Social Science Survey, Peking University, Beijing, China
| | - Xinxin Chen
- Institute for Social Science Survey, Peking University, Beijing, China
| | - Weihua Li
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.
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Liu C, Chen R, Zhao Y, Ma Z, Bi J, Liu Y, Meng X, Wang Y, Chen X, Li W, Kan H. Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017. [PMID: 28153400 DOI: 10.1016/j.scitotenv.2017.01.133%5bpublished] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Limited evidence is available regarding the long-term effects of fine particulate (PM2.5) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM2.5 with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM2.5 for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM2.5 and hypertension prevalence and linear regression models for the associations between PM2.5 and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM2.5 for all participants was 72.8μg/m3 on average. An interquartile range increase (IQR, 41.7μg/m3) in PM2.5 was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM2.5. The effects of PM2.5 on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM2.5 was associated with increased prevalence of hypertension and slightly higher systolic BP in China.
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Affiliation(s)
- Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Lab of Meteorology and Health, Shanghai, China
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Yafeng Wang
- Institute for Social Science Survey, Peking University, Beijing, China
| | - Xinxin Chen
- Institute for Social Science Survey, Peking University, Beijing, China
| | - Weihua Li
- Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.
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Chen SY, Chan CC, Su TC. Particulate and gaseous pollutants on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 223:403-408. [PMID: 28159399 DOI: 10.1016/j.envpol.2017.01.037] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/14/2017] [Accepted: 01/15/2017] [Indexed: 05/28/2023]
Abstract
This study examined effects of short-term urban air pollution exposures on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease (CVD). We enrolled 61 patients with multiple CVD risk factors and measured high sensitive C-reactive protein (hs-CRP), fibrinogen, D-dimer, and heart rate variability (HRV) indices. Two health examinations for each participant were performed during December 2002 through September 2003. Changes in inflammation and thrombotic markers and HRV indices with exposures to PM2.5, organic carbon (OC), elemental carbon (EC), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) at 1- to 3-day lags were analyzed using mixed models. The results showed inflammatory and thrombotic markers increased with 1- to 3-day lagged PM2.5 components and gaseous pollutants exposures. hs-CRP maximally increased 0.19 [95% confidence interval (CI): 0.07-0.31] and 0.15 (95% CI: 0.05-0.24) mg/L for an interquartile range (IQR) of 1-day lagged SO2 (2.3 ppb) and CO (0.5 ppm), respectively. D-dimer maximally increased 1.05 (95% CI: 0.13-1.75), 0.72 (95% CI: 0.09-1.21), 0.92 (95% CI: 0.13-1.50), and 0.90 (95% CI: 0.07-1.61) mg/dL for an IQR of 1-day lagged OC (3.9 μg/m3), EC (2.0 μg/m3), SO2, and NO2 (13.4 ppb), respectively. The HRV indices, including low frequency, very low frequency, and the ratio of low frequency to high frequency decreased 19.8 (95% CI: 4.4-32.7), 12.9 (95% CI: 0.8-23.4), and 17.6 (95% CI: 5.4-28.2)% for an IQR of 1-day lagged PM2.5 (20.2 μg/m3), respectively. Our findings demonstrated PM2.5 components and gaseous pollutants exert prolonged inflammatory and thrombotic reactions, while PM2.5 exert an immediate autonomic imbalance.
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Affiliation(s)
- Szu-Ying Chen
- Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Chen Su
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan.
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Coogan PF, White LF, Yu J, Brook RD, Burnett RT, Marshall JD, Bethea TN, Rosenberg L, Jerrett M. Long-Term Exposure to NO2 and Ozone and Hypertension Incidence in the Black Women's Health Study. Am J Hypertens 2017; 30:367-372. [PMID: 28096146 PMCID: PMC5861564 DOI: 10.1093/ajh/hpw168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence shows that exposure to air pollutants can increase blood pressure in the short and long term. Some studies show higher levels of hypertension prevalence in areas of high pollution. Few data exist on the association of air pollution with hypertension incidence. The purpose of the present study was to prospectively assess the associations of the traffic-related nitrogen dioxide (NO2) and of ozone with the incidence of hypertension in the Black Women's Health Study (BWHS), a large cohort study of African American women. METHODS We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for hypertension associated with exposure to NO2 and ozone among 33,771 BWHS participants. NO2 and ozone levels at participant residential locations were estimated with validated models. RESULTS From 1995 to 2011, 9,570 incident cases of hypertension occurred in a total of 348,154 person-years (median follow-up time, 11 years). The multivariable HRs per interquartile range of NO2 (9.7 ppb) and ozone (6.7 ppb) were 0.92 (95% CI = 0.86, 0.98) and 1.09 (95% CI = 1.00, 1.18). CONCLUSIONS In this large cohort of African American women, higher ozone levels were associated with an increase in hypertension incidence. Higher NO2 levels were not associated with greater hypertension incidence; indeed, incidence was lower at higher NO2 levels.
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Affiliation(s)
| | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey Yu
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Richard T Burnett
- Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Julian D Marshall
- Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Traci N Bethea
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences and Center for Occupational and Environmental Health, Fielding School of Public Health, University of California, Los Angeles, USA
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