Residential proximity to major roadways and incident hypertension in post-menopausal women.
Living near major roadways has been associated with increased risk of cardiovascular morbidity and mortality, presumably from exposure to elevated levels of traffic-related air and/or noise pollution. This association may potentially be mediated through increased risk of incident hypertension, but results from prior studies are equivocal. Using Cox proportional hazards models we examined residential proximity to major roadways and incident hypertension among 38,360 participants of the Women's Health Initiative (WHI) Clinical Trial cohorts free of hypertension at enrollment and followed for a median of 7.9 years. Adjusting for participant demographics and lifestyle, trial participation, and markers of individual and neighborhood socioeconomic status, the hazard ratios for incident hypertension were 1.13 (95% CI: 1.00, 1.28), 1.03 (0.95, 1.11), 1.05 (0.99, 1.11), and 1.05 (1.00, 1.10) for participants living ≤50, >50-200, >200-400, and >400-1000 m vs >1000 m from the nearest major roadway, respectively (ptrend=0.013). This association varied substantially by WHI study region with hazard ratios for women living ≤50 m from a major roadway of 1.61 (1.18, 2.20) in the West, 1.51 (1.22, 1.87) in the Northeast, 0.89 (0.70, 1.14) in the South, and 0.94 (0.75, 1.19) in the Midwest. In this large, national cohort of post-menopausal women, residential proximity to major roadways was associated with incident hypertension in selected regions of the U.S. If causal, these results suggest residential proximity to major roadways, as a marker for air, noise and other traffic-related pollution, may be a risk factor for hypertension.
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Samantha L
SL
Kingsley
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Melissa N
MN
Eliot
Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA.
Eric A
EA
Whitsel
Department of Environmental Health Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
Yi
Y
Wang
Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.
Brent A
BA
Coull
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Lifang
L
Hou
Department of Internal Medicine, School of Medicine, University of California, Davis, CA, USA.
Helene G
HG
Margolis
Health Partners Institute for Education and Research, Minneapolis, MN, USA.
Karen L
KL
Margolis
Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
Lina
L
Mu
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Providence Veterans Affairs Medical Center, Providence, RI, USA.
Wen-Chih C
WC
Wu
Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Karen C
KC
Johnson
Department of Family and Preventive Medicine, University of California San Diego School of Medicine, San Diego, CA, USA.
Matthew A
MA
Allison
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
JoAnn E
JE
Manson
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Memorial Hospital of Rhode Island, Pawtucket, RI, USA.
Charles B
CB
Eaton
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. Electronic address: Gregory_wellenius@brown.edu.
Gregory A
GA
Wellenius
D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D015331:Cohort Studies; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009624:Noise, Transportation / Q000009:adverse effects*; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D014481:United States; D001335:Vehicle Emissions / Q000032:analysis
D000393:Air Pollutants; D001335:Vehicle Emissions
Air pollution; Blood pressure; Hypertension; Noise pollution; Traffic pollution; Women