title: Long-Term Effects of Ambient PM2.5on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults.
abstract: Long-term exposure to ambient fine particulate pollution (PM2.5) has been associated with cardiovascular diseases. Hypertension, a major risk factor for cardiovascular diseases, has also been hypothesized to be linked to PM2.5However, epidemiological evidence has been mixed. We examined long-term association between ambient PM2.5and hypertension and blood pressure. We interviewed 12 665 participants aged 50 years and older and measured their blood pressures. Annual average PM2.5concentrations were estimated for each community using satellite data. We applied 2-level logistic regression models to examine the associations and estimated hypertension burden attributable to ambient PM2.5For each 10 μg/m3increase in ambient PM2.5, the adjusted odds ratio of hypertension was 1.14 (95% confidence interval, 1.07-1.22). Stratified analyses found that overweight and obesity could enhance the association, and consumption of fruit was associated with lower risk. We further estimated that 11.75% (95% confidence interval, 5.82%-18.53%) of the hypertension cases (corresponding to 914, 95% confidence interval, 453-1442 cases) could be attributable to ambient PM2.5in the study population. Findings suggest that long-term exposure to ambient PM2.5might be an important risk factor of hypertension and is responsible for significant hypertension burden in adults in China. A higher consumption of fruit may mitigate, whereas overweight and obesity could enhance this effect.
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Hualiang
authors.initials: H
authors.lastname: Lin
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Guo
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Qian
authors.initials: Q
authors.lastname: Di
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Xiao
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Weilin
authors.initials: W
authors.lastname: Zeng
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Lenise A
authors.initials: LA
authors.lastname: Cummings-Vaughn
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Howard
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vaughn
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO. zqian2@slu.edu mawj@gdiph.org.cn wufan@scdc.sh.cn.
authors.forename: Zhengmin Min
authors.initials: ZM
authors.lastname: Qian
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Ma
authors.affiliation: From the Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, China (H.L., T.L., J.X., X.L., W.Z., W.M.); Shanghai Municipal Centre for Disease Control and Prevention, China (Y.G., Y.Z., F.W.); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (Q.D.); Division of Geriatrics and Nutritional Science, School of Medicine, Washington University in St. Louis, MO (L.A.C.-V.); and Department of Health Management and Policy (S.W.H.), School of Social Work (M.G.V.), and Department of Epidemiology (Z.M.Q.), College for Public Health and Social Justice, Saint Louis University, MO.
authors.forename: Fan
authors.initials: F
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution; D001794:Blood Pressure / Q000502:physiology*; D002681:China; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: air pollution; blood pressure; hypertension; obesity; risk factors