Interactions Between Air Pollution and Obesity on Blood Pressure and Hypertension in Chinese Children

Dong, Guang‐Hui; Wang, Jing; Zeng, Xiao‐Wen; Chen, Lihua; Qin, Xiaodi; Zhou, Yang; Li, Meng; Yang, Minxian; Zhao, Yang; Ren, Weirong; Hu, Qiansheng

doi:10.1097/ede.0000000000000336

Cited by 86 publications

(62 citation statements)

References 29 publications

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“…We observed a stronger positive association between PM and hypertension in obese participants, similar to two other studies (Dong et al 2015; Zhao et al 2013) that reported that obesity may amplify the association of long-term air pollution exposure with hypertension in China. The mechanism underlying the synergistic effects of PM and obesity on hypertension is not clear; one possible explanation is that obesity and exposures to PM both result in systemic inflammation (Dubowsky et al 2006).…”

Section: Discussionsupporting

confidence: 91%

“…Several studies have examined the impact of a number of different air pollutants on the prevalence of hypertension, and overall, most have suggested increased prevalence with increasing exposures (Babisch et al 2014; Chen et al 2015; Dong et al 2013, 2015; Foraster et al 2014a; Fuks et al 2011; Johnson and Parker 2009; Sørensen et al 2012). Increases in air pollution have also been associated with increases in the number of emergency-department visits for hypertension in Edmonton, Canada (Szyszkowicz et al 2012), and with hospital admissions for hypertension in a study from Brazil (Arbex et al 2010).…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Exposure to Particulate Matter and Self-Reported Hypertension: A Prospective Analysis in the Nurses’ Health Study

Zhang

Laden

Forman

et al. 2016

Environ Health Perspect

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Background:Studies have suggested associations between elevated blood pressure and short-term air pollution exposures, but the evidence is mixed regarding long-term exposures on incidence of hypertension.Objectives:We examined the association of hypertension incidence with long-term residential exposures to ambient particulate matter (PM) and residential distance to roadway.Methods:We estimated 24-month and cumulative average exposures to PM10, PM2.5, and PM2.5–10 and residential distance to road for women participating in the prospective nationwide Nurses’ Health Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for incident hypertension from 1988 to 2008 using Cox proportional hazards models adjusted for potential confounders. We considered effect modification by age, diet, diabetes, obesity, region, and latitude.Results:Among 74,880 participants, 36,812 incident cases of hypertension were observed during 960,041 person-years. In multivariable models, 10-μg/m3 increases in 24-month average PM10, PM2.5, and PM2.5–10 were associated with small increases in the incidence of hypertension (HR: 1.02, 95% CI: 1.00, 1.04; HR: 1.04, 95% CI: 1.00, 1.07; and HR: 1.03, 95% CI: 1.00, 1.07, respectively). Associations were stronger among women < 65 years of age (HR: 1.04, 95% CI: 1.01, 1.06; HR: 1.07, 95% CI: 1.02, 1.12; and HR: 1.05, 95% CI: 1.01, 1.09, respectively) and the obese (HR: 1.07, 95% CI: 1.04, 1.12; HR: 1.15, 95% CI: 1.07, 1.23; and HR: 1.13, 95% CI: 1.07, 1.19, respectively), with p-values for interaction < 0.05 for all models except age and PM2.5–10. There was no association with roadway proximity.Conclusions:Long-term exposure to particulate matter was associated with small increases in risk of incident hypertension, particularly among younger women and the obese.Citation:Zhang Z, Laden F, Forman JP, Hart JE. 2016. Long-term exposure to particulate matter and self-reported hypertension: a prospective analysis in the Nurses’ Health Study. Environ Health Perspect 124:1414–1420; http://dx.doi.org/10.1289/EHP163

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Long-Term Exposure to Particulate Matter and Self-Reported Hypertension: A Prospective Analysis in the Nurses’ Health Study

Zhang

Laden

Forman

et al. 2016

Environ Health Perspect

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“…Wave 1 was conducted to assess the relationship of outdoor and indoor air pollution with asthma and asthma‐related symptoms in children using among 31 049 children from 25 districts of the seven cities in Northeastern China . Wave 2, which occurred in 2012‐2013, was conducted to evaluate the effects of air pollution on lung function, blood pressure, and mental health, including attention deficit hyperactivity disorder (ADHD) and sleep disorder . While the seven cities were the same, a total of 70 000 new children were randomly selected from 48 kindergartens, 24 elementary school, and 24 middle schools.…”

Section: Methodsmentioning

confidence: 99%

Pre-natal and post-natal exposure to pet ownership and lung function in children: The Seven Northeastern Cities Study

Qian

Dharmage

et al. 2017

Indoor Air

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To evaluate the association between pre-natal and post-natal exposure to pet ownership and lung function in children, a cross-sectional study named Seven Northeastern Cities (SNEC) study was conducted. In this study, children's lung function including the forced expiratory volume in 1 second (FEV ), forced vital capacity (FVC), maximal mid-expiratory flow (MMEF), and peak expiratory flow (PEF) were measured by spirometers, and pet ownership situations were collected by questionnaire. Analyzed by multiple logistic regression and generalized linear modeling, we found that for all subjects, pet exposure in the first 2 years of life was significantly associated with lung function impairment of FVC<85% predicted (adjusted odds ratio [aOR]=1.28; 95% confidence interval [CI]: 1.01, 1.63). For current pet exposure, the increased odds of lung function impairment ranged from 35% (aOR=1.35; 95%CI: 1.12, 1.62) for FVC<85% predicted to 57% (aOR=1.57; 95%CI: 1.29, 1.93) for FEV <85% predicted. The in utero exposure was not related to lung function impairment. Compared with other pets, higher odds were observed among children with dogs. When stratified by gender, girls with current pet exposure were more likely to have lung function impairment than boys. It implies self-reported exposures to pets were negatively associated with lung function among the children under study.

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“…It is possible that short-term effect of air pollution on BP in children is stronger than long-term effect. The estimated short-term associations of exposure with hypertension in the SNEC study were stronger than the long-term associations [71,75]. For example, the estimated ORs of PM 10 with hypertension in boys, given per interquartile range, were 1.79-2.22 for short-term and 1.55 for long-term exposure [71,75].…”

Section: Effects In Vulnerable Subgroups 41 Childrenmentioning

confidence: 80%

Outdoor Air Pollution and Arterial Hypertension

Li¹,

Yang²,

Fan³

et al. 2018

Blood Pressure - From Bench to Bed

Self Cite

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Air pollution is a major environmental risk factor. There is accumulating evidence that air pollution could induce elevated blood pressure and potentiate hypertension. Acute elevations in the outdoor air pollution levels can trigger immediate or shortly delayed increases in arterial blood pressure. Moreover, few studies suggest that short-term increases in the levels of particulate and gaseous pollutants could lead to an acute onset of hypertension. Prolonged exposure to outdoor air pollution is associated with elevated blood pressure. Furthermore, some longitudinal studies have linked long-term exposure to air pollution with the incidence of hypertension. Various components of air pollution, such as inhalable particulate matter (PM 2.5 ,PM 10), nitrogen oxides, sulfur dioxide, and ozone, have shown associations with blood pressure in some studies. The hypothesized underlying mechanisms include inflammatory reactions and oxidative stress in lungs and in systemic circulation, imbalance of autonomous nervous system, and pathologic changes in vascular endothelium. In addition to "traditional" susceptible groups such as elderly individuals or patients with chronic diseases, children and pregnant women could be especially susceptible to the adverse effects of air pollution. The interplay of air pollution with the related environmental exposures, such as traffic noise and climate change, should be investigated further.

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Interactions Between Air Pollution and Obesity on Blood Pressure and Hypertension in Chinese Children

Abstract: Obesity amplifies the association of long-term air pollution exposure with blood pressure and hypertension in Chinese children.

Cited by 86 publications

References 29 publications

Long-Term Exposure to Particulate Matter and Self-Reported Hypertension: A Prospective Analysis in the Nurses’ Health Study

Long-Term Exposure to Particulate Matter and Self-Reported Hypertension: A Prospective Analysis in the Nurses’ Health Study

Pre-natal and post-natal exposure to pet ownership and lung function in children: The Seven Northeastern Cities Study

Outdoor Air Pollution and Arterial Hypertension

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