title: Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension: A Systematic Review and Meta-Analysis.
abstract: Hypertension is a major disease of burden worldwide. Previous studies have indicated that air pollution might be a risk factor for hypertension, but the results were controversial. To fill this gap, we performed a meta-analysis of epidemiological studies to investigate the associations of short-term and long-term exposure to ambient air pollutants with hypertension. We searched all of the studies published before September 1, 2015, on the associations of ozone (O3), carbon monoxide (CO), nitrogen oxide (NO2 and NOX), sulfur dioxide (SO2), and particulate matter (PM10 and PM2.5) with hypertension in the English electronic databases. A pooled odds ratio (OR) for hypertension in association with each 10 μg/m(3) increase in air pollutant was calculated by a random-effects model (for studies with significant heterogeneity) or a fixed-effect model (for studies without significant heterogeneity). A total of 17 studies examining the effects of short-term (n=6) and long-term exposure (n=11) to air pollutants were identified. Short-term exposure to SO2 (OR=1.046, 95% confidence interval [CI]: 1.012-1.081), PM2.5 (OR=1.069, 95% CI: 1.003-1.141), and PM10 (OR=1.024, 95% CI: 1.016-1.032) were significantly associated with hypertension. Long-term exposure (a 10 μg/m(3) increase) to NO2 (OR=1.034, 95% CI: 1.005-1.063) and PM10 (OR=1.054, 95% CI: 1.036-1.072) had significant associations with hypertension. Exposure to other ambient air pollutants (short-term exposure to NO2, O3, and CO and long-term exposure to NOx, PM2.5, and SO2) also had positive relationships with hypertension, but lacked statistical significance. Our results suggest that short-term or long-term exposure to some air pollutants may increase the risk of hypertension.
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Cai
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Weixia
authors.initials: W
authors.lastname: Ke
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Baixiang
authors.initials: B
authors.lastname: Feng
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Hualiang
authors.initials: H
authors.lastname: Lin
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Xiao
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Weilin
authors.initials: W
authors.lastname: Zeng
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Jun
authors.initials: J
authors.lastname: Tao
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.).
authors.forename: Zuyao
authors.initials: Z
authors.lastname: Yang
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.). mawj@gdiph.org.cn gztt_2002@163.com.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Ma
authors.affiliation: From the Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, China (Y.C., B.Z.); Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, China (Y.C., B.Z.); Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China (W.K., B.F., H.L., J.X., W.Z., X.L., W.M., T.L.); South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, 510085, China (J.T.); and Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999000, China (Z.Y.). mawj@gdiph.org.cn gztt_2002@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis; D016001:Confidence Intervals; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D009589:Nitrogen Oxides / Q000009:adverse effects / Q000032:analysis; D016017:Odds Ratio; D010126:Ozone / Q000009:adverse effects / Q000032:analysis; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D018570:Risk Assessment; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D009589:Nitrogen Oxides; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone; D002248:Carbon Monoxide
keywords: air pollution; hypertension; long-term exposure; meta-analysis; short-term exposure