Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China.
Limited evidence is available regarding the long-term effects of fine particulate (PM2.5) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM2.5with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM2.5for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM2.5and hypertension prevalence and linear regression models for the associations between PM2.5and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM2.5for all participants was 72.8μg/m3on average. An interquartile range increase (IQR, 41.7μg/m3) in PM2.5was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM2.5. The effects of PM2.5on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM2.5was associated with increased prevalence of hypertension and slightly higher systolic BP in China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
Cong
C
Liu
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Lab of Meteorology and Health, Shanghai, China.
Renjie
R
Chen
National School of Development, Peking University, Beijing, China.
Yaohui
Y
Zhao
State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China.
Zongwei
Z
Ma
State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, Jiangsu Province, China.
Jun
J
Bi
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Yang
Y
Liu
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Xia
X
Meng
Institute for Social Science Survey, Peking University, Beijing, China.
Yafeng
Y
Wang
Institute for Social Science Survey, Peking University, Beijing, China.
Xinxin
X
Chen
Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.
Weihua
W
Li
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Key Lab of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China. Electronic address: kanh@fudan.edu.cn.
Haidong
H
Kan
D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015233:Models, Statistical; D052638:Particulate Matter / Q000009:adverse effects
D000393:Air Pollutants; D052638:Particulate Matter
Ambient air pollution; Blood pressure; Cross-sectional study; Fine particulate matter; Hypertension