Arterial blood pressure and long-term exposure to traffic-related air pollution: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE).
BACKGROUND
Long-term exposure to air pollution has been hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country specific.


OBJECTIVE
We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hypertension in European populations.


METHODS
We analyzed 15 population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). We modeled residential exposure to particulate matter and nitrogen oxides with land use regression using a uniform protocol. We assessed traffic exposure with traffic indicator variables. We analyzed systolic and diastolic BP in participants medicated and nonmedicated with BP-lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hypertension was defined as ≥ 140 mmHg systolic BP, or ≥ 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis.


RESULTS
In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in nonmedicated participants [0.35 mmHg (95% CI: 0.02, 0.68) and 0.22 mmHg (95% CI: 0.04, 0.40) per 4,000,000 vehicles × m/day, respectively]. The estimated odds ratio (OR) for prevalent hypertension was 1.05 (95% CI: 0.99, 1.11) per 4,000,000 vehicles × m/day. Modeled air pollutants and BP were not clearly associated.


CONCLUSIONS
In this first comprehensive meta-analysis of European population-based cohorts, we observed a weak positive association of high residential traffic exposure with BP in nonmedicated participants, and an elevated OR for prevalent hypertension. The relationship of modeled air pollutants with BP was inconsistent.
IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
Kateryna B
KB
Fuks
Gudrun
G
Weinmayr
Maria
M
Foraster
Julia
J
Dratva
Regina
R
Hampel
Danny
D
Houthuijs
Bente
B
Oftedal
Anna
A
Oudin
Sviatlana
S
Panasevich
Johanna
J
Penell
Johan N
JN
Sommar
Mette
M
Sørensen
Pekka
P
Tiittanen
Kathrin
K
Wolf
Wei W
WW
Xun
Inmaculada
I
Aguilera
Xavier
X
Basagaña
Rob
R
Beelen
Michiel L
ML
Bots
Bert
B
Brunekreef
H Bas
HB
Bueno-de-Mesquita
Barbara
B
Caracciolo
Marta
M
Cirach
Ulf
U
de Faire
Audrey
A
de Nazelle
Marloes
M
Eeftens
Roberto
R
Elosua
Raimund
R
Erbel
Bertil
B
Forsberg
Laura
L
Fratiglioni
Jean-Michel
JM
Gaspoz
Agneta
A
Hilding
Antti
A
Jula
Michal
M
Korek
Ursula
U
Krämer
Nino
N
Künzli
Timo
T
Lanki
Karin
K
Leander
Patrik K E
PK
Magnusson
Jaume
J
Marrugat
Mark J
MJ
Nieuwenhuijsen
Claes-Göran
CG
Ostenson
Nancy L
NL
Pedersen
Göran
G
Pershagen
Harish C
HC
Phuleria
Nicole M
NM
Probst-Hensch
Ole
O
Raaschou-Nielsen
Emmanuel
E
Schaffner
Tamara
T
Schikowski
Christian
C
Schindler
Per E
PE
Schwarze
Anne J
AJ
Søgaard
Dorothea
D
Sugiri
Wim J R
WJ
Swart
Ming-Yi
MY
Tsai
Anu W
AW
Turunen
Paolo
P
Vineis
Annette
A
Peters
Barbara
B
Hoffmann
D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000706:statistics & numerical data; D000959:Antihypertensive Agents / Q000627:therapeutic use; D062186:Arterial Pressure; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D009589:Nitrogen Oxides / Q000032:analysis / Q000633:toxicity; D009624:Noise, Transportation / Q000706:statistics & numerical data; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D012307:Risk Factors; D001335:Vehicle Emissions / Q000032:analysis / Q000633:toxicity*
D000393:Air Pollutants; D000959:Antihypertensive Agents; D009589:Nitrogen Oxides; D052638:Particulate Matter; D001335:Vehicle Emissions