Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross-sectional associations of 24-hour mean concentrations of personal and kitchen fine particulate matter (PM ), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner-burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24-hour PM concentrations of 126 μg/m (77) and 360 μg/m (374), while Justa stove users' exposures were 66 μg/m (38) and 137 μg/m (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7-4.3) per unit increase in natural log-transformed kitchen PM concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3-8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0-2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.

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Authors' contributions SR performed the data collection, analyzed the data and wrote the manuscript. BNY performed the data collection and wrote the manuscript. MLC designed the study and revised the manuscript. MLBC performed the data collection and revised the manuscript. AMB designed the study and revised the manuscript. RDB designed the study and revised the manuscript. TLN revised the manuscript. JV supported the data collection and revised the manuscript. SJR revised the manuscript. CL supported the data collection and revised the manuscript. NG supported the data analysis and revised the manuscript. KK revised the manuscript. SA supported data collection and revised the manuscript. ABOP supported data collection and revised the manuscript. JLP designed the study and revised the manuscript. All authors read and approved the final manuscript.