Associations of long-term exposure to ambient ozone with hypertension, blood pressure, and the mediation effects of body mass index: A national cross-sectional study of middle-aged and older adults in China

Long-term Exposure to Ambient Ozone at Workplace is Positively and Non-linearly Associated with Incident Hypertension and Blood Pressure: Longitudinal Evidence from the Beijing-Tianjin-Hebei Medical Examination Cohort

“…Although the relationship between ambient pollutants and blood pressure or hypertension has been enormously investigated, the impacts of long-term exposure to O 3 on hypertension were much less addressed [4,39,40]. Prior to our study, several cross-sectional studies reported inconsistent relationships of long-term exposure to O 3 with prevalent hypertension, however, its association with incident hypertension was seldom investigated [10,39]. One prospective cohort study in black women found that every 6.7 ppb increment of O 3 exposure was associated with a 9% (HR: 1.09; 95% CI: 1.00, 1.18) higher risk of incident hypertension based on the single-pollutant model with adjustment for potential covariates.…”

“…Though a few positive ndings regarding the effects of long-term ozone exposure on elevated SBP, DBP and MAP, no signi cant ndings have been reported regarding the relationship between long-term ozone exposure and elevated PP [10,13,14]. Determined by the compliance of arteries and the timing and intensity of arterial wave re ections, PP is usually considered as an indicator of arterial stiffness [45].…”

“…Studies on the health impact of ozone have mostly focused on respiratory disease [8,9], while evidence for hypertensive effects of O 3 exposure remains scarce, especially for long-term exposure to O 3 . Moreover, the results of the association between long-term exposure to O 3 and hypertension have been mixed, with some reporting positive associations [10,11], some nding adverse associations [12], and the others showing non-signi cant associations [13,14]. Due to the very limited number of association studies between long-term O 3 exposure and hypertension, even a systematic review could not reach a robust conclusion on the plausibility of its association with hypertension [4].…”

“…Due to the very limited number of association studies between long-term O 3 exposure and hypertension, even a systematic review could not reach a robust conclusion on the plausibility of its association with hypertension [4]. In addition, most of the existing studies are limited by their cross-sectional design [10][11][12]14]. The only two cohort studies were both conducted in speci c populations, African American population with a high (56%) prevalence of hypertension [13] and American black women [15].…”

A time-series analysis of short-term ambient ozone exposure and hospitalizations from acute myocardial infarction in Henan, China

“…In addition, a study on healthy individuals showed that exposure to O 3 resulted in elevated plasma levels of in ammatory markers(Kim et al 2011, Pirozzi et al 2015 and that in ammatory mediators can enter the circulatory system and stimulate platelet activation(Day et al 2017) and the release of coagulation factors(Münzel et al 2017), increasing the chances of thrombosis and promoting coronary events. O 3 exposure may also be associated with changes in the autonomic nervous system(Arjomandi et al 2015, Jia et al 2011) and blood pressure(Niu et al 2022); however, some studies have found a protective effect of O 3 on ischemic myocardium(Wang et al 2022, Yu et al 2021). To complement the traditional exposure risk assessment, we evaluated the number of AMI hospitalizations, hospitalization days, and hospitalization costs attributable to O 3 .…”