title: Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease.
abstract: OBJECTIVE
  Epidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events. We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease.
  
  
  METHODS
  60 Patients (50p 1-3 vessels disease; 10p with a high Framingham Score of 23%) were exposed in random and blinded order to aircraft noise and no noise conditions. Noise was simulated in the patients' bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (flow-mediated dilation of the brachial artery), questionnaires and blood sampling were performed on the morning after each study night.
  
  
  RESULTS
  The mean sound pressure levels L eq(3) measured were 46.9 ± 2.0 dB(A) in the Noise 60 nights and 39.2 ± 3.1 dB(A) in the control nights. Subjective sleep quality was markedly reduced by noise from 5.8 ± 2.0 to 3.7 ± 2.2 (p < 0.001). FMD was significantly reduced (from 9.6 ± 4.3 to 7.9 ± 3.7%; p < 0.001) and systolic blood pressure was increased (from 129.5 ± 16.5 to 133.6 ± 17.9 mmHg; p = 0.030) by noise. The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity.
  
  
  CONCLUSIONS
  Nighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.
authors.affiliation: 2 Medical Clinic, Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Schmidt
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Kolle
authors.forename: Katharina
authors.initials: K
authors.lastname: Kreuder
authors.forename: Boris
authors.initials: B
authors.lastname: Schnorbus
authors.forename: Philip
authors.initials: P
authors.lastname: Wild
authors.forename: Marlene
authors.initials: M
authors.lastname: Hechtner
authors.forename: Harald
authors.initials: H
authors.lastname: Binder
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000401:Aircraft; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D018592:Cross-Over Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005858:Germany; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D009624:Noise, Transportation / Q000009:adverse effects*; D011312:Pressure; D018570:Risk Assessment; D012307:Risk Factors; D016037:Single-Blind Method; D012890:Sleep; D011795:Surveys and Questionnaires; D013997:Time Factors; D014664:Vasodilation