title: The association of annual air pollution exposure with blood pressure among patients with sleep-disordered breathing.
abstract: While sleep-disordered breathing (SDB), high blood pressure (BP) and air pollution exposure have separately been associated with increased risk of cardiopulmonary mortality, the association linking air pollution exposure to BP among patients with sleep-disordered breathing is still unclear. We collected 3762 participants' data from the Taipei Medical University Hospital's Sleep Center and air pollution data from the Taiwan Environmental Protection Administration. Associations of 1-year mean criteria air pollutants [particulate matter with aerodynamic diameters ≤10 μm (PM10), particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5), nitrogen dioxide (NO2) and ozone (O3)] with systolic BP (SBP) and diastolic BP (DBP) were investigated by generalized additive models. After controlling for age, sex, body mass index (BMI), temperature and relative humidity, we observed that increases in air pollution levels were associated with decreased SBP and increased DBP. We also found that patients with apnea-hypopnea index (AHI) ≥30 showed a stronger BP response to increased levels of air pollution exposure than those with AHI<30. Stronger effects of air pollution exposure on BP were found in overweight participants than in participants with normal BMI. We concluded that annual exposure to air pollution was associated with change of BP among patients with sleep-disordered breathing. The association between annual air pollution exposure and BP could be modified by AHI and BMI.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Engineering Science, National Cheng Kung University, Tainan, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Wen-Te
authors.initials: WT
authors.lastname: Liu
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kang-Yun
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsiao-Chi
authors.initials: HC
authors.lastname: Chuang
authors.affiliation: Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Dean
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Engineering Science, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jer-Nan
authors.initials: JN
authors.lastname: Juang
authors.affiliation: Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. Electronic address: kjc@tmu.edu.tw.
authors.forename: Kai-Jen
authors.initials: KJ
authors.lastname: Chuang
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000706:statistics & numerical data*; D001794:Blood Pressure; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D010126:Ozone; D009585:Nitrogen Dioxide
keywords: Air pollution; Apnea–hypopnea index; Blood pressure; Epidemiology; Sleep-disordered breathing