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

Na Li; Gongbo Chen; Feifei Liu; Shuyuan Mao; Yisi Liu; Suyang Liu; Zongfu Mao; Yuanan Lu; Chongjian Wang; Yuming Guo; Hao Xiang; Shanshan Li

doi:10.1016/j.envres.2019.109109

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

Na Li, Gongbo Chen, Feifei Liu, Shuyuan Mao, Yisi Liu, Suyang Liu, Zongfu Mao, Yuanan Lu, Chongjian Wang, Yuming Guo, Hao Xiang, Shanshan Li

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96 Scopus citations

Abstract

Background: Studies on the hypertensive effect of long-term air pollution exposure were inconclusive and showed scarce evidence from rural areas in developing countries. In this context, we examined the associations of air pollution exposure with hypertension and blood pressure, and their effect modifiers in rural Chinese adults. Methods: We studied 39,259 participants from a cohort established in five rural regions of central China. Individual exposures to PM_2.5 and PM₁₀ (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm and 10 μm) and nitrogen dioxide (NO₂) was evaluated using satellite-based spatiotemporal models. Mixed-effect regression models were applied to examine the associations of long-term exposure to air pollution with hypertension and four blood pressure component measurements, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Several potential effect modifiers related to demographic and behavioral factors were also examined. Results: The results showed that for each 1 μg/m³ increase in PM_2.5, PM₁₀ and NO₂, the adjusted odds ratio of hypertension was 1.029 (95%CI: 1.001,1.057), 1.015 (95%CI: 1.001, 1.029) and 1.069 (95%CI: 1.038, 1.100), respectively. These three air pollutants were also associated with increased SBP (except for PM₁₀), DBP and MAP. The hypertensive effects of air pollution were more pronounced among males, smokers, drinkers, individuals with a high-fat diet, and those with high-level physical activity. Conclusion: Long-term exposure to PM_2.5, PM₁₀ and NO₂ was associated with increased blood pressure and hypertension in rural Chinese adults, and the associations were modified by several behavioral factors.

Original language	English
Article number	109109
Journal	Environmental Research
Volume	182
DOIs	https://doi.org/10.1016/j.envres.2019.109109
State	Published - Mar 2020

Bibliographical note

Publisher Copyright:
© 2020 The Author(s)

Funding

This work was supported by the Foundation of National Key Program of Research and Development of China (Grant No. 2016YFC0900803), National Natural Science Foundation of China of China (Grant No. 81903279), the Bill & Melinda Gates Foundation (Grant No. OOP1148464), and the Natural Science Fund of Hubei Province (Grant No. 2018CFB634). Dr. Guo is supported by Career Development Fellowship APP1107107 from the Australian National Health and Medical Research Council (NHMRC). Dr. S. Li is supported by Early Career Fellowship APP1109193 from the Australian NHMRC. This work was supported by the Foundation of National Key Program of Research and Development of China (Grant No. 2016YFC0900803 ), National Natural Science Foundation of China of China (Grant No. 81903279 ), the Bill & Melinda Gates Foundation (Grant No. OOP1148464 ), and the Natural Science Fund of Hubei Province (Grant No. 2018CFB634 ). Dr. Guo is supported by Career Development Fellowship APP1107107 from the Australian National Health and Medical Research Council (NHMRC). Dr. S. Li is supported by Early Career Fellowship APP1109193 from the Australian NHMRC .

Funders	Funder number
Foundation of National Key Program of Research and Development of China
Bill and Melinda Gates Foundation	OOP1148464
Bill and Melinda Gates Foundation
Australian National Health and Medical Research Council	APP1109193
Australian National Health and Medical Research Council
National Natural Science Foundation of China (NSFC)	81903279
National Natural Science Foundation of China (NSFC)
Natural Science Foundation of Hubei Province	APP1107107, 2018CFB634
Natural Science Foundation of Hubei Province
National Key Research and Development Program of China Stem Cell and Translational Research	2016YFC0900803
National Key Research and Development Program of China Stem Cell and Translational Research

Keywords

Air pollution
Blood pressure
Effect modification
Hypertension
Rural China

ASJC Scopus subject areas

Biochemistry
General Environmental Science

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10.1016/j.envres.2019.109109

Cite this

@article{b17d4a5ec34743efb91d96ef359e9464,

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

abstract = "Background: Studies on the hypertensive effect of long-term air pollution exposure were inconclusive and showed scarce evidence from rural areas in developing countries. In this context, we examined the associations of air pollution exposure with hypertension and blood pressure, and their effect modifiers in rural Chinese adults. Methods: We studied 39,259 participants from a cohort established in five rural regions of central China. Individual exposures to PM2.5 and PM10 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm and 10 μm) and nitrogen dioxide (NO2) was evaluated using satellite-based spatiotemporal models. Mixed-effect regression models were applied to examine the associations of long-term exposure to air pollution with hypertension and four blood pressure component measurements, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Several potential effect modifiers related to demographic and behavioral factors were also examined. Results: The results showed that for each 1 μg/m3 increase in PM2.5, PM10 and NO2, the adjusted odds ratio of hypertension was 1.029 (95\%CI: 1.001,1.057), 1.015 (95\%CI: 1.001, 1.029) and 1.069 (95\%CI: 1.038, 1.100), respectively. These three air pollutants were also associated with increased SBP (except for PM10), DBP and MAP. The hypertensive effects of air pollution were more pronounced among males, smokers, drinkers, individuals with a high-fat diet, and those with high-level physical activity. Conclusion: Long-term exposure to PM2.5, PM10 and NO2 was associated with increased blood pressure and hypertension in rural Chinese adults, and the associations were modified by several behavioral factors.",

keywords = "Air pollution, Blood pressure, Effect modification, Hypertension, Rural China",

author = "Na Li and Gongbo Chen and Feifei Liu and Shuyuan Mao and Yisi Liu and Suyang Liu and Zongfu Mao and Yuanan Lu and Chongjian Wang and Yuming Guo and Hao Xiang and Shanshan Li",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s)",

year = "2020",

month = mar,

doi = "10.1016/j.envres.2019.109109",

language = "English",

volume = "182",

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TY - JOUR

T1 - Associations between long-term exposure to air pollution and blood pressure and effect modifications by behavioral factors

AU - Li, Na

AU - Chen, Gongbo

AU - Liu, Feifei

AU - Mao, Shuyuan

AU - Liu, Yisi

AU - Liu, Suyang

AU - Mao, Zongfu

AU - Lu, Yuanan

AU - Wang, Chongjian

AU - Guo, Yuming

AU - Xiang, Hao

AU - Li, Shanshan

PY - 2020/3

Y1 - 2020/3

N2 - Background: Studies on the hypertensive effect of long-term air pollution exposure were inconclusive and showed scarce evidence from rural areas in developing countries. In this context, we examined the associations of air pollution exposure with hypertension and blood pressure, and their effect modifiers in rural Chinese adults. Methods: We studied 39,259 participants from a cohort established in five rural regions of central China. Individual exposures to PM2.5 and PM10 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm and 10 μm) and nitrogen dioxide (NO2) was evaluated using satellite-based spatiotemporal models. Mixed-effect regression models were applied to examine the associations of long-term exposure to air pollution with hypertension and four blood pressure component measurements, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Several potential effect modifiers related to demographic and behavioral factors were also examined. Results: The results showed that for each 1 μg/m3 increase in PM2.5, PM10 and NO2, the adjusted odds ratio of hypertension was 1.029 (95%CI: 1.001,1.057), 1.015 (95%CI: 1.001, 1.029) and 1.069 (95%CI: 1.038, 1.100), respectively. These three air pollutants were also associated with increased SBP (except for PM10), DBP and MAP. The hypertensive effects of air pollution were more pronounced among males, smokers, drinkers, individuals with a high-fat diet, and those with high-level physical activity. Conclusion: Long-term exposure to PM2.5, PM10 and NO2 was associated with increased blood pressure and hypertension in rural Chinese adults, and the associations were modified by several behavioral factors.

AB - Background: Studies on the hypertensive effect of long-term air pollution exposure were inconclusive and showed scarce evidence from rural areas in developing countries. In this context, we examined the associations of air pollution exposure with hypertension and blood pressure, and their effect modifiers in rural Chinese adults. Methods: We studied 39,259 participants from a cohort established in five rural regions of central China. Individual exposures to PM2.5 and PM10 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm and 10 μm) and nitrogen dioxide (NO2) was evaluated using satellite-based spatiotemporal models. Mixed-effect regression models were applied to examine the associations of long-term exposure to air pollution with hypertension and four blood pressure component measurements, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Several potential effect modifiers related to demographic and behavioral factors were also examined. Results: The results showed that for each 1 μg/m3 increase in PM2.5, PM10 and NO2, the adjusted odds ratio of hypertension was 1.029 (95%CI: 1.001,1.057), 1.015 (95%CI: 1.001, 1.029) and 1.069 (95%CI: 1.038, 1.100), respectively. These three air pollutants were also associated with increased SBP (except for PM10), DBP and MAP. The hypertensive effects of air pollution were more pronounced among males, smokers, drinkers, individuals with a high-fat diet, and those with high-level physical activity. Conclusion: Long-term exposure to PM2.5, PM10 and NO2 was associated with increased blood pressure and hypertension in rural Chinese adults, and the associations were modified by several behavioral factors.

KW - Air pollution

KW - Blood pressure

KW - Effect modification

KW - Hypertension

KW - Rural China

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U2 - 10.1016/j.envres.2019.109109

DO - 10.1016/j.envres.2019.109109

M3 - Article

C2 - 32069739

AN - SCOPUS:85077662410

SN - 0013-9351

VL - 182

JO - Environmental Research

JF - Environmental Research

M1 - 109109

ER -

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

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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