Impacts of Short-Term Fine Particulate Matter Exposure on Blood Pressure Were Modified by Control Status and Treatment in Hypertensive Patients.

Published on Jun 1, 2021in Hypertension7.713
· DOI :10.1161/HYPERTENSIONAHA.120.16611
Zhennan Lin (Peking Union Medical College), Xinyan Wang3
Estimated H-index: 3
(Peking Union Medical College)
+ 14 AuthorsJianfeng Huang35
Estimated H-index: 35
(Peking Union Medical College)
Previous studies revealed that fine particulate matter (PM2.5) exposure adversely affected blood pressure (BP), but factors that might attenuate this association were still unclear. Using a multicenter panel study among 277 hypertensive participants with intermediate-to-high risk of cardiovascular disease from 4 cities in China, we aimed to explore whether BP control status and antihypertensive medications were potential modifying factors. Each participant carried personal-portable monitors to record individual real-time PM2.5 levels and 24-hour ambulatory BP up to 3× within 1 year. Generalized linear mixed model with individual-specific random intercept was used to assess effect sizes. We identified adverse impacts of short-term PM2.5 exposure on BP. However, these impacts were attenuated among patients with controlled BP. For example, per interquartile range (43.78 µg/m3) increment in the prior 10-hour moving average of PM2.5, systolic BP increased -0.20 (95% CI, -0.57 to 0.18) mm Hg and 0.85 (95% CI, 0.36-1.35) mm Hg among those with controlled and uncontrolled BP, respectively (Pinteraction, 0.0009). Furthermore, among those with uncontrolled BP, treatment with angiotensin receptor blocker would potentially lower BP in responses to PM2.5, with systolic BP associated with per interquartile range increment in 10-hour moving average PM2.5 of 0.32 (95% CI, -0.37 to 1.00) mm Hg and 1.53 (95% CI, 0.74-2.33) mm Hg among those taking angiotensin receptor blocker or not, respectively (Pinteraction, 0.0229). In conclusion, although PM2.5 exposure would increase BP, keeping well-controlled BP status and using angiotensin receptor blockers might attenuate these adverse impacts, which might provide supporting evidence for guiding hypertensive patients who live in areas with high level of PM2.5.
📖 Papers frequently viewed together
21 Citations
2 Authors (Eva Lonn, Salim Yusuf)
13 Citations
4 Citations
#1Licheng Zhang (Capital Medical University)H-Index: 3
#2Ji An (Capital Medical University)H-Index: 4
Last. Yanxia Luo (Capital Medical University)H-Index: 15
view all 10 authors...
Exposure to ambient particulate matter with a diameter of <2.5 mum (PM2.5) has been linked to increases in blood pressure. The aim of this study was to assess the effects of short-term exposure to PM2.5 on blood pressure in office workers in Beijing, China. A total of 4801 individuals aged 18-60 years underwent an annual medical examination between 2013 and 2017. Levels of air pollutants were obtained from 35 fixed monitoring stations and correlated with the employment location of each participa...
1 CitationsSource
#1Dieyi Chen (RMIT: RMIT University)H-Index: 7
#2Fatemeh Mayvaneh (HSU: Hakim Sabzevari University)H-Index: 6
Last. Yunquan Zhang (WUST: Wuhan University of Science and Technology)H-Index: 22
view all 13 authors...
Abstract Background Evidence for associations between fine particulate matter (PM2.5) and cardiovascular diseases (CVDs) in Iran is scarce. Given large within-day variations of PM2.5 concentration, using the daily mean of PM2.5 (PM2.5mean) as exposure metric might bias the health-related assessment. This study applied a novel indicator, daily excessive concentration hours (DECH), to evaluate the effect of ambient PM2.5 on CVD mortality and years of life lost (YLL) in Tehran, the capital city of ...
7 CitationsSource
#1Jinlei Qi (CCDC: Chinese Center for Disease Control and Prevention)H-Index: 15
#2Zengliang Ruan (SYSU: Sun Yat-sen University)H-Index: 9
Last. Hualiang Lin (SYSU: Sun Yat-sen University)H-Index: 18
view all 8 authors...
Background Ambient fine particulate matter pollution (PM2.5) is one leading cause of disease burden, but no study has quantified the association between daily PM2.5 exposure and life expectancy. We aimed to assess the potential benefits in life expectancy by attaining the daily PM2.5 standards in 72 cities of China during 2013–2016. Methods and findings We applied a two-stage approach for the analysis. At the first stage, we used a generalized additive model (GAM) with a Gaussian link to examine...
44 CitationsSource
#1Meng Ren (SYSU: Sun Yat-sen University)H-Index: 8
#2Huanhuan Zhang (SYSU: Sun Yat-sen University)H-Index: 8
Last. Cunrui Huang (SYSU: Sun Yat-sen University)H-Index: 26
view all 8 authors...
Abstract Background Short-term exposure to PM2.5 has been shown to be associated with changes in blood pressure. However, most of the evidence is based on PM2.5 measurements from fixed stations and resting blood pressure measured at a regular time. Objectives To evaluate the short-term daily and hourly effects of real-time personal PM2.5 exposure on ambulatory blood pressure, and to compare the effects with those of PM2.5 exposure from fixed stations. Methods Between April 2017 and December 2017...
4 CitationsSource
#1Siqi Ai (SYSU: Sun Yat-sen University)H-Index: 7
#2Changke Wang (CMA: China Meteorological Administration)H-Index: 3
Last. Hualiang Lin (SYSU: Sun Yat-sen University)H-Index: 18
view all 11 authors...
Abstract Background Most studies on the short-term health effects of air pollution have been conducted on a daily time scale, while hourly associations remain unclear. Methods We collected the hourly data of emergency ambulance calls (EACs), ambient air pollution, and meteorological variables from 2014 to 2016 in Luoyang, a central Chinese city in Henan Province. We used a generalized additive model to estimate the hourly effects of ambient air pollutants (PM2.5, PM10, SO2, and NO2) on EACs for ...
11 CitationsSource
#1Wen-Yi Yang (Katholieke Universiteit Leuven)H-Index: 17
#2Jesus D. Melgarejo (University of Zulia)H-Index: 9
Last. Jan A. Staessen (UM: Maastricht University)H-Index: 138
view all 26 authors...
Importance Blood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes. Objective To evaluate the association of BP indexes with death and a composite CV event. Design, Setting, and Participants Longitudinal population-based cohort study of 11 135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010...
87 CitationsSource
#1Jeffrey D. StanawayH-Index: 49
#2Ashkan AfshinH-Index: 55
Last. Christopher J L MurrayH-Index: 220
view all 1043 authors...
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome p...
27 CitationsSource
#1Xiuduan Xu (Anhui Medical University)H-Index: 3
#2Huan Xu (Anhui Medical University)H-Index: 3
Last. Lun Song (Guangxi Medical University)H-Index: 6
view all 7 authors...
Abstract Acute and chronic exposure to particulate matter (PM) 2.5 is associated with adverse health effect upon the cardiovascular (CV) system. However, the molecular mechanism by which PM2.5 evokes CV injuries has not been fully clarified. In our recent report, we demonstrate that exposure to PM2.5 leads to elevation of circulating angiotensin II (ANGII) levels and local expressions of angiotensinogen (AGT, the precursor of ANGII), angiotensin-converting enzyme (ACE) and ANGII type 1 receptor ...
8 CitationsSource
#1Yaohua Tian (PKU: Peking University)H-Index: 16
#2Hui Liu (PKU: Peking University)H-Index: 8
Last. Yonghua Hu (PKU: Peking University)H-Index: 29
view all 14 authors...
Background Epidemiological studies have provided compelling evidence of associations between ambient temperature and cardiovascular disease. However, evidence of effects of daily temperature variability on cardiovascular disease is scarce and mixed. We aimed to examine short-term associations between temperature variability and hospital admissions for cause-specific cardiovascular disease in urban China. Methods and findings We conducted a national time-series analysis in 184 cities in China bet...
38 CitationsSource
#1Jeffrey D. Stanaway (UW: University of Washington)H-Index: 49
#1Jeffrey D. Stanaway (UW: University of Washington)H-Index: 17
Last. Christopher J L Murray (UW: University of Washington)H-Index: 220
view all 1043 authors...
Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework dev...
1,209 CitationsSource
Cited By0