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Long-Term Exposure to Outdoor and Household Air Pollution and Blood Pressure in the Prospective Urban and Rural Epidemiological (Pure) Study Publisher Pubmed



Arku RE1, 2 ; Brauer M2 ; Ahmed SH3 ; Alhabib KF4 ; Avezum A5 ; Bo J6 ; Choudhury T7 ; Dans AM8 ; Gupta R9 ; Iqbal R10 ; Ismail N11 ; Kelishadi R12 ; Khatib R13 ; Koon T14 Show All Authors
Authors
  1. Arku RE1, 2
  2. Brauer M2
  3. Ahmed SH3
  4. Alhabib KF4
  5. Avezum A5
  6. Bo J6
  7. Choudhury T7
  8. Dans AM8
  9. Gupta R9
  10. Iqbal R10
  11. Ismail N11
  12. Kelishadi R12
  13. Khatib R13
  14. Koon T14
  15. Kumar R15
  16. Lanas F16
  17. Lear SA17
  18. Wei L6
  19. Lopezjaramillo P18
  20. Mohan V19
  21. Poirier P20
  22. Puoane T21
  23. Rangarajan S14
  24. Rosengren A22
  25. Soman B23
  26. Caklili OT24
  27. Yang S25
  28. Yeates K26
  29. Yin L6
  30. Yusoff K27
  31. Zatonski T28
  32. Yusuf S14
  33. Hystad P29
Show Affiliations
Authors Affiliations
  1. 1. Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, United States
  2. 2. School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
  3. 3. Dubai Health Authority, United Arab Emirates
  4. 4. College of Medicine, King Saud University, Saudi Arabia
  5. 5. Dante Pazzanese Institute of Cardiology and University of Santo Amaro, Sao Paulo, Brazil
  6. 6. Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
  7. 7. Independent University, Bangladesh
  8. 8. Philippine General Hospital, Manila, Philippines
  9. 9. Eternal Heart Care Centre and Research Institute, Jaipur, India
  10. 10. Departments of Community Health Sciences and Medicine, The Aga Khan University, Karachi, Pakistan
  11. 11. Faculty of Medicine, University Kebangsaan, Kuala Lumpur, Malaysia
  12. 12. Cardiovascular Research Institute, Isfahan University of Medical Sciences, Iran
  13. 13. Advocate Research Institute, Advocate Health Care, Downers Grove, IL, United States
  14. 14. Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
  15. 15. School of Public Health, PGIMER, Chandigarh, India
  16. 16. Universidad de La Frontera, Temuco, Chile
  17. 17. Simon Fraser University, Vancouver, Canada
  18. 18. Research Institute FOSCAL and Masira Institute, UDES, Bucaramanga, Colombia
  19. 19. Madras Diabetes Research Foundation, Chennai, India
  20. 20. Universite Laval and Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
  21. 21. School of Public Health, University of the Western Cape, Bellville, South Africa
  22. 22. University of Gothenburg and Sahlgrenska University Hospital Gothenburg, Sweden
  23. 23. Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
  24. 24. Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Turkey
  25. 25. Center for Disease Control and Prevention, Yunnan, China
  26. 26. Queen's University, Kingston, Ontario, Canada
  27. 27. UCSI University, Kuala Lumpur, Malaysia & Universiti Teknologi MARA, Selayang, Malaysia
  28. 28. Department of Otolaryngology Head and Neck Surgery, Medical University, Wroclaw, Poland
  29. 29. School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States

Source: Environmental Pollution Published:2020


Abstract

Exposure to air pollution has been linked to elevated blood pressure (BP) and hypertension, but most research has focused on short-term (hours, days, or months) exposures at relatively low concentrations. We examined the associations between long-term (3-year average) concentrations of outdoor PM2.5 and household air pollution (HAP) from cooking with solid fuels with BP and hypertension in the Prospective Urban and Rural Epidemiology (PURE) study. Outdoor PM2.5 exposures were estimated at year of enrollment for 137,809 adults aged 35–70 years from 640 urban and rural communities in 21 countries using satellite and ground-based methods. Primary use of solid fuel for cooking was used as an indicator of HAP exposure, with analyses restricted to rural participants (n = 43,313) in 27 study centers in 10 countries. BP was measured following a standardized procedure and associations with air pollution examined with mixed-effect regression models, after adjustment for a comprehensive set of potential confounding factors. Baseline outdoor PM2.5 exposure ranged from 3 to 97 μg/m3 across study communities and was associated with an increased odds ratio (OR) of 1.04 (95% CI: 1.01, 1.07) for hypertension, per 10 μg/m3 increase in concentration. This association demonstrated non-linearity and was strongest for the fourth (PM2.5 > 62 μg/m3) compared to the first (PM2.5 < 14 μg/m3) quartiles (OR = 1.36, 95% CI: 1.10, 1.69). Similar non-linear patterns were observed for systolic BP (β = 2.15 mmHg, 95% CI: −0.59, 4.89) and diastolic BP (β = 1.35, 95% CI: −0.20, 2.89), while there was no overall increase in ORs across the full exposure distribution. Individuals who used solid fuels for cooking had lower BP measures compared to clean fuel users (e.g. 34% of solid fuels users compared to 42% of clean fuel users had hypertension), and even in fully adjusted models had slightly decreased odds of hypertension (OR = 0.93; 95% CI: 0.88, 0.99) and reductions in systolic (−0.51 mmHg; 95% CI: −0.99, −0.03) and diastolic (−0.46 mmHg; 95% CI: −0.75, −0.18) BP. In this large international multi-center study, chronic exposures to outdoor PM2.5 was associated with increased BP and hypertension while there were small inverse associations with HAP. © 2020 Elsevier Ltd
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