SHORT-TERM EXPOSURE TO AMBIENT AIR POLLUTION AND BLOOD PRESSURE IN THE FRAMINGHAM HEART STUDY

AbstractElevated blood pressure (BP) has been proposed as a possible pathophysiological mechanism linking exposure to ambient air pollution and the increased risk of cardiovascular mortality and morbidity. In this study, we investigated the hourly relationship between ambient air pollutants and BP. BP measurements were extracted from the electronic health record database of the Seoul National University Bundang Hospital from February 2015 to June 2017. A total of 98,577 individual BP measurements were matched to the hourly levels of air pollutants. A generalized additive model was constructed for hour lags of 0–8 of air pollutants adjusting for age, sex, meteorological variables, and time trend. Systolic BP was shown to be significantly lower at 2–4 hours and 3–5 hours after increased levels of SO2 and CO, respectively (0.24 mmHg and 0.26 mmHg for an interquartile range, respectively). In contrast, O3 and NO2 were associated with significantly increased systolic BP at 3–5 lag hours and at 0–2 lag hours, respectively. BP elevation in association with O3 and NO2 was shown to be significantly greater in hypertensive patients than normotensive subjects. Our findings suggest that short-term exposure to air pollution may be associated with elevated BP.

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The Association Between Short-term Exposure to Ambient Air Pollution and Patient-Level Home Blood Pressure Among Patients With Chronic Cardiovascular Diseases in a Web-Based Synchronous Telehealth Care Program: Retrospective Study (Preprint)

10.2196/preprints.26605 ◽

2020 ◽

Author(s):

Ching-Chang Huang ◽

Ying-Hsien Chen ◽

Chi-Sheng Hung ◽

Jen-Kuang Lee ◽

Tse-Pin Hsu ◽

...

Keyword(s):

Blood Pressure ◽

Air Pollution ◽

Air Pollutants ◽

Meteorological Factors ◽

Care Program ◽

Ambient Air ◽

Home Blood Pressure ◽

Ambient Air Pollution ◽

Short Term ◽

Short Term Exposure

BACKGROUND The association between short-term exposure to ambient air pollution and blood pressure has been inconsistent, as reported in the literature. OBJECTIVE This study aimed to investigate the relationship between short-term ambient air pollution exposure and patient-level home blood pressure (HBP). METHODS Patients with chronic cardiovascular diseases from a telehealth care program at a university-affiliated hospital were enrolled as the study population. HBP was measured by patients or their caregivers. Hourly meteorological data (including temperature, relative humidity, wind speed, and rainfall) and ambient air pollution monitoring data (including CO, NO<sub>2</sub>, particulate matter with a diameter of <10 µm, particulate matter with a diameter of <2.5 µm, and SO<sub>2</sub>) during the same time period were obtained from the Central Weather Bureau and the Environmental Protection Administration in Taiwan, respectively. A stepwise multivariate repeated generalized estimating equation model was used to assess the significant factors for predicting systolic and diastolic blood pressure (SBP and DBP). RESULTS A total of 253 patients and 110,715 HBP measurements were evaluated in this study. On multivariate analysis, demographic, clinical, meteorological factors, and air pollutants significantly affected the HBP (both SBP and DBP). All 5 air pollutants evaluated in this study showed a significant, nonlinear association with both home SBP and DBP. Compared with demographic and clinical factors, environmental factors (meteorological factors and air pollutants) played a minor yet significant role in the regulation of HBP. CONCLUSIONS Short-term exposure to ambient air pollution significantly affects HBP in patients with chronic cardiovascular disease.

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The Association Between Short-term Exposure to Ambient Air Pollution and Patient-Level Home Blood Pressure Among Patients With Chronic Cardiovascular Diseases in a Web-Based Synchronous Telehealth Care Program: Retrospective Study

JMIR Public Health and Surveillance ◽

10.2196/26605 ◽

2021 ◽

Vol 7 (6) ◽

pp. e26605

Author(s):

Ching-Chang Huang ◽

Ying-Hsien Chen ◽

Chi-Sheng Hung ◽

Jen-Kuang Lee ◽

Tse-Pin Hsu ◽

...

Keyword(s):

Blood Pressure ◽

Air Pollution ◽

Air Pollutants ◽

Meteorological Factors ◽

Care Program ◽

Ambient Air ◽

Home Blood Pressure ◽

Ambient Air Pollution ◽

Short Term ◽

Short Term Exposure

Background The association between short-term exposure to ambient air pollution and blood pressure has been inconsistent, as reported in the literature. Objective This study aimed to investigate the relationship between short-term ambient air pollution exposure and patient-level home blood pressure (HBP). Methods Patients with chronic cardiovascular diseases from a telehealth care program at a university-affiliated hospital were enrolled as the study population. HBP was measured by patients or their caregivers. Hourly meteorological data (including temperature, relative humidity, wind speed, and rainfall) and ambient air pollution monitoring data (including CO, NO2, particulate matter with a diameter of <10 µm, particulate matter with a diameter of <2.5 µm, and SO2) during the same time period were obtained from the Central Weather Bureau and the Environmental Protection Administration in Taiwan, respectively. A stepwise multivariate repeated generalized estimating equation model was used to assess the significant factors for predicting systolic and diastolic blood pressure (SBP and DBP). Results A total of 253 patients and 110,715 HBP measurements were evaluated in this study. On multivariate analysis, demographic, clinical, meteorological factors, and air pollutants significantly affected the HBP (both SBP and DBP). All 5 air pollutants evaluated in this study showed a significant, nonlinear association with both home SBP and DBP. Compared with demographic and clinical factors, environmental factors (meteorological factors and air pollutants) played a minor yet significant role in the regulation of HBP. Conclusions Short-term exposure to ambient air pollution significantly affects HBP in patients with chronic cardiovascular disease.

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