Ambient pollution and blood pressure in cardiac rehabilitation patients.
BACKGROUND
Multiple studies have demonstrated a consistent association between ambient particulate air pollution and increased risk of hospital admissions and deaths for cardiovascular causes. We investigated the associations between fine particulate pollution (PM2.5) and blood pressure during 631 repeated visits for cardiac rehabilitation in 62 Boston residents with cardiovascular disease.


RESULTS
Blood pressure, cardiac risk factor, and exercise data were abstracted from records of rehabilitation visits between 1999 and 2001. We applied mixed-effect models, controlling for body mass index, age, gender, number of visits, hour of day, and weather variables. For an increase from the 10th to the 90th percentile in mean PM2.5 level during the 5 days before the visit (10.5 microg/m3), there was a 2.8-mm Hg (95% CI, 0.1 to 5.5) increase in resting systolic, a 2.7-mm Hg (95% CI, 1.2 to 4.3) increase in resting diastolic, and a 2.7-mm Hg (95% CI, 1.0 to 4.5) increase in resting mean arterial blood pressure. The mean PM2.5 level during the 2 preceding days (13.9 microg/m3) was associated with a 7.0-mm Hg (95% CI, 2.3 to 12.1) increase in diastolic and a 4.7-mm Hg (95% CI, 0.5 to 9.1) increase in mean arterial blood pressure during exercise in persons with resting heart rate > or =70 bpm, but it was not associated with an increase in blood pressure during exercise in persons with heart rate <70 bpm.


CONCLUSIONS
In patients with preexisting cardiac disease, particle pollution may contribute to increased risk of cardiac morbidity and mortality through short-term increases in systemic arterial vascular narrowing, as manifested by increased peripheral blood pressure.
Department of Environmental Health, Exposure Epidemiology and Risk Program, Harvard School of Public Health, 401 Park Dr, Landmark Center, Suite 415, PO Box 15698, Boston, Mass 02215, USA. azanobet@hsph.harvard.edu
Antonella
A
Zanobetti
Marina Jacobson
MJ
Canner
Peter H
PH
Stone
Joel
J
Schwartz
David
D
Sher
Elizabeth
E
Eagan-Bengston
Karen A
KA
Gates
L Howard
LH
Hartley
Helen
H
Suh
Diane R
DR
Gold
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects* / Q000494:pharmacology; D000397:Air Pollution / Q000009:adverse effects*; D015992:Body Mass Index; D001900:Boston / Q000453:epidemiology; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D015331:Cohort Studies; D015897:Comorbidity; D003971:Diastole; D005081:Exercise Therapy; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008685:Meteorological Concepts; D008875:Middle Aged; D010316:Particle Size; D012307:Risk Factors; D013599:Systole; D014661:Vasoconstriction / Q000187:drug effects
D000393:Air Pollutants