Impact of household solid fuel use on blood pressure and hypertension among adults in China

Abstract

The widespread use of solid fuel as primary household energy resource has been demonstrated to be linked to significant adverse health effects. However, limited studies examined the cardiovascular-related health effects of household solid fuel exposure, especially from the view of blood pressure (BP) measurements, a leading risk factor for cardiovascular diseases. Using a large-scale population-based data, this study evaluated the association between household solid fuel exposure and adults' blood pressure as well as hypertension in nine provinces of China. Multiple linear regression and logistic regression models were used to estimate the coefficients, odd ratios (ORs), and the corresponding 95 % confidence intervals (CI). After adjusting for potential confounders, we observed a 0.75 % (95 % CI 0.74-0.76 %, p < 0.05) higher systolic blood pressure (SBP) and 1.05 % (95 % CI 1.04-1.06 %, p < 0.01) higher diastolic blood pressure (DBP) in current solid fuel users. Users with longest duration of solid fuel exposure had a 1.63 % (95 % CI 1.62-1.64 %, p < 0.01) higher SBP and 1.31 % (95 % CI 1.30-1.32 %, p < 0.01) higher DBP than non-users. Besides, current use of solid fuel also was associated with an increased risk for hypertension (OR = 1.11, 95 % CI 1.11-1.12 %). Compared with non-users, those with the longest duration of solid fuel also experienced a larger risk of hypertension with an OR of 1.55 (95 % CI 1.54-1.56 %). The findings suggest that solid fuel exposure may link to higher blood pressure and elevated risk of hypertension in adults in China.

Associations of household solid fuel for heating and cooking with hypertension in Chinese adults

“…Our nding of no consistent association between cooking and heating with solid fuels and hypertension and blood pressure is different from previous studies conducted in China that identi ed a potential increased risk with solid fuel use (8,15,16,19,34). For example, one of them involved only 209 adults in China and reported a signi cantly increased SBP of 3.80% per IQR evaluation of indoor and outdoor PM2.5 level with a 2 days' lag; however, this small Chinese study did not examine the potential long-term effect on blood pressure and the association with speci c household heating source was not addressed (8).…”

“…Excluding center from models increased the OR for hypertension to 1.23 (95% CI: 1.13, 1.33) for individuals heating with solid fuels compared to the clean fuels (Table S2) which is similar to the nding of other studies conducted in China (15,16); however, these results may not re ect all of the random intercept caused by center. Including center in our models controls for regional differences and restricted our comparisons to individuals living with the same regions of China.…”

“…Household solid fuel use for cooking and hypertension has been investigated by several epidemiological studies with mixed ndings (9)(10)(11)(12)(13)(14)(15)(16). A study examining 137,809 individuals from ten countries in the Prospective Urban and Rural Epidemiology (PURE) study observed no association between cooking with solid fuels and hypertension or blood pressure (9).…”

“…However, in China, solid fuel use for heating and cooking is high (4,5), and heating may be more important to PM2.5 exposures than cooking (17). Until now, only two cross-sectional studies conducted in China have examined the association between using household solid fuels and hypertension prevalence and reported a positive association (15,16), but both of them were not distinguish the effect of cooking from heating, or the combined effect of using solid fuels for heating and cooking. Recent evidence has shown that long-term exposure to ambient PM2.5 may harm blood vessels and increase blood pressure via increasing in ammatory factors and oxidative stress (18,19), but more research is needed to determine if heating and cooking with solid fuels are a potential modi able source of air pollution exposure that could decrease hypertension and blood pressure.…”

National and sub-national age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to household air pollution from solid cookfuel use (HAP) in Iran, 1990–2013

“…There are evidences indicating association between household solid fuel use and a number of other health outcomes such as asthma, hypertension, low birth weight, etc. that the causes do not still meet the inclusion criteria of the GBD (Kim et al, 2011;Yan et al, 2016). Indoor air pollution is not only limited to solid fuel use, but other sources including household furnishings, consumer products, and nonsolid fuel (kerosene, LPG, PNG, etc.)…”