A panel study of the acute effects of personal exposure to household air pollution on ambulatory blood pressure in rural Indian women

Abstract Background Limited data suggest that household air pollution from cooking and heating with solid fuel (i.e., coal and biomass) stoves may contribute to the development of hypertension and vascular damage. Methods Using mixed-effects regression models, we investigated the associations of household air pollution with blood pressure (BP) and vascular function in 753 adults (ages 40-79y) from three diverse provinces in China. We conducted repeated measures of participants’ household fuel use, personal exposure to fine particulate air pollution (PM2.5), BP, brachial-femoral pulse wave velocity (bfPWV), and augmentation index. Ultrasound images of the carotid arteries were obtained to assess intima-media thickness (CIMT) and plaques. Covariate information on socio-demographics, health behaviors, 24-h urinary sodium, and blood lipids was also obtained. Results Average estimated yearly personal exposure to PM2.5 was 97.5 μg/m 3 (SD: 79.2; range: 3.5-1241), and 65% of participants cooked with solid fuel. In multivariable models, current solid fuel use was associated with higher systolic (2.4 mmHg, 95%CI: -0.4, 4.9) and diastolic BP (1.4 mmHg, 95%CI: -0.1, 3.0) and greater total area of plaques (1.7 mm 2, 95%CI: -6.5, 9.8) compared with exclusive use of electricity or gas stoves. A 1-ln(µg/m 3) increase in PM2.5 exposure was associated with higher systolic (1.5 mmHg, 95%CI: 0.2, 2.7) and diastolic BP (1.0 mmHg, 95%CI: 0.4, 1.7) and with greater CIMT (0.02 mm, 95%CI: 0.00, 0.04) and total area of plaques (4.7 mm 2, 95%CI: -2.0, 11.5). We did not find associations with arterial stiffness, except for a lower bfPWV (-1.5 m/s, 95%CI: -3.0, -0.0) among users of solid fuel heaters. Conclusions These findings add to limited evidence that household air pollution is associated with higher BP and with greater CIMT and total plaque area.

Download Full-text

Abstract 17973: Biomass Fuel Use is Associated With Elevated Blood Pressure and Hypertension Status in Puno, Peru

Circulation ◽

10.1161/circ.130.suppl_2.17973 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Melissa S Burroughs Pena ◽

Karina Romero ◽

Antonio Bernabe Ortiz ◽

Eric J Velazquez ◽

J. Jaime Miranda ◽

...

Keyword(s):

Blood Pressure ◽

Air Pollution ◽

Systolic Blood Pressure ◽

Self Report ◽

Biomass Fuel ◽

Household Air Pollution ◽

Biomass Fuels ◽

Fuel Use ◽

The Impact ◽

The Relationship

Background: Household air pollution from biomass fuel use affects 3 billion people worldwide. There are few studies that examine the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with higher blood pressure and increased hypertension in Peru. Methods: We analyzed baseline information from an age- and sex-matched, population-based study in Puno, Peru. Daily biomass fuel use was self-reported. Hypertension was defined as a systolic blood pressure (SBP) ≥140 mmHg; diastolic blood pressure (DBP) ≥90 mmHg; or self-report of diagnosis and anti-hypertensive medications. We used linear and logistic multivariable regressions, adjusting for age, sex, daily cigarette use and body mass index, to examine the relationship between daily biomass fuel use with blood pressure and hypertension, respectively. Results: Data from 1004 individuals (mean age 55.3 years, 51.7% female) were included. There was evidence of an association between daily biomass fuel use and hypertension (adjusted OR = 2.1, 95%CI 1.2 to 3.5). Subjects who reported daily use of biomass fuels had 6.0 mmHg (95% CI 4.1 to 8.0) higher SBP and 4.8 mmHg (95%CI 3.5 to 6.0) higher DBP compared to those who did not use biomass fuels daily. In a secondary analysis, we used rural residence (vs. urban) as a proxy of biomass daily use and the relationship with hypertension and systolic blood pressure was similar: a higher odds of hypertension (adjusted OR = 2.1, 95%CI 1.3 to 3.6), and higher SBP (6.7mmHg, 95% CI 4.8 to 8.6) and DBP (5.5 mmHg, 95% CI 4.3 to 6.8) in rural vs. urban participants. Conclusion: Biomass fuel use is associated with increased odds of hypertension and higher blood pressure in Puno, Peru. Reducing exposure to air pollution from biomass fuel use represents a potential opportunity for cardiovascular prevention in rural communities worldwide. Longitudinal studies to evaluate the impact of reducing household air pollution are needed.

Download Full-text