TY - JOUR
T1 - Global association between ambient air pollution and blood pressure
T2 - A systematic review and meta-analysis
AU - Yang, Bo Yi
AU - Qian, Zhengmin
AU - Howard, Steven W.
AU - Vaughn, Michael G.
AU - Fan, Shu Jun
AU - Liu, Kang Kang
AU - Dong, Guang Hui
N1 - Funding Information:
This work was supported by grants from the National Key Research and Development Program of China (grant number 2016YFC0207000 ); the Fundamental Research Funds for the Central Universities (No. 16ykzd02 ; 17ykpy16 ); and the National Natural Science Foundation of China (No. 91543208 ; No. 81703179 ).
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/4
Y1 - 2018/4
N2 - Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter<2.5 μm (PM2.5), 2.5–10 μm (PM2.5-10) or >10 μm (PM10)) and gaseous (sulfur dioxide (SO2), nitrogen dioxide (NO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM2.5 with hypertension (OR = 1.05), and of PM10, PM2.5, and NO2 with DBP (β values: 0.47–0.86 mmHg). In addition, short-term exposures to four (PM10, PM2.5, SO2, NO2), two (PM2.5 and SO2), and four air pollutants (PM10, PM2.5, SO2, and NO2), were significantly associated with hypertension (ORs: 1.05–1.10), SBP (β values: 0.53–0.75 mmHg) and DBP (β values: 0.15–0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants. Meta-analysis shows significant associations between ambient air pollution and hypertension.
AB - Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter<2.5 μm (PM2.5), 2.5–10 μm (PM2.5-10) or >10 μm (PM10)) and gaseous (sulfur dioxide (SO2), nitrogen dioxide (NO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM2.5 with hypertension (OR = 1.05), and of PM10, PM2.5, and NO2 with DBP (β values: 0.47–0.86 mmHg). In addition, short-term exposures to four (PM10, PM2.5, SO2, NO2), two (PM2.5 and SO2), and four air pollutants (PM10, PM2.5, SO2, and NO2), were significantly associated with hypertension (ORs: 1.05–1.10), SBP (β values: 0.53–0.75 mmHg) and DBP (β values: 0.15–0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants. Meta-analysis shows significant associations between ambient air pollution and hypertension.
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U2 - 10.1016/j.envpol.2018.01.001
DO - 10.1016/j.envpol.2018.01.001
M3 - Review article
C2 - 29331891
AN - SCOPUS:85040255418
SN - 0269-7491
VL - 235
SP - 576
EP - 588
JO - Environmental Pollution
JF - Environmental Pollution
ER -