Ambient particulate air pollution and blood pressure in peri-urban India

Curto Tirado, Ariadna, 1987-; Wellenius, Gregory A.; Milà, Carles; Sanchez, Margaux; Ranzani, Otavio; Marshall, Julian D.; Kulkarni, Bharati; Bhogadi, Santhi; Kinra, Sanjay; Tonne, Cathryn

doi:http://dx.doi.org/10.1097/EDE.0000000000001014

Ambient particulate air pollution and blood pressure in peri-urban India

Citation

Curto A, Wellenius GA, Milà C, Sanchez M, Ranzani O, Marshall JD, Kulkarni B, Bhogadi S, Kinra S, Tonne C. Ambient particulate air pollution and blood pressure in peri-urban India. Epidemiology. 2019; 30(4):492-500. DOI 10.1097/EDE.0000000000001014

Abstract

BACKGROUND: Evidence linking long-term exposure to particulate air pollution to blood pressure (BP) in high-income countries may not be transportable to low- and middle-income countries. We examined cross-sectional associations between ambient fine particulate matter (PM2.5) and black carbon (BC) with BP (systolic [SBP] and diastolic [DBP]) and prevalent hypertension in adults from 28 peri-urban villages near Hyderabad, India. METHODS: We studied 5531 participants from the Andhra Pradesh Children and Parents Study (18-84 years, 54% men). We measured BP (2010-2012) in the right arm and defined hypertension as SBP ≥130 mmHg and/or DBP ≥80 mmHg. We used land-use regression models to estimate annual average PM2.5 and BC at participant's residence. We applied linear and logistic nested mixed-effect models stratified by sex and adjusted by cooking fuel type to estimate associations between within-village PM2.5 or BC and health. RESULTS: Mean (SD) PM2.5 was 33 µg/m (2.7) and BC was 2.5 µg/m (0.23). In women, a 1 µg/m increase in PM2.5 was associated with 1.4 mmHg higher SBP (95% confidence interval [CI]: 0.12, 2.7), 0.87 mmHg higher DBP (95% CI: -0.18, 1.9), and 4% higher odds of hypertension (95% CI: 0%, 9%). In men, associations with SBP (0.52 mmHg; 95% CI: -0.82, 1.8), DBP (0.41 mmHg; 95% CI: -0.69, 1.5), and hypertension (2% higher odds; 95% CI: -2%, 6%) were weaker. No associations were observed with BC. CONCLUSION: We observed a positive association between ambient PM2.5 and BP and hypertension in women. Longitudinal studies in this region are needed to corroborate our findings.