Citation: Dzhambov AM, Tokmakova MP, Gatseva PD, Zdravkov NG, Gencheva DG, Ivanova NG, Karastanev KI, Vladeva SV, Donchev AT, Dermendzhiev SM. Community noise exposure and its eff ect on blood pressure and renal function in patients with hypertension and cardiovascular disease.Folia Medica 2017;59(3): 344-356. doi: 10.1515/folmed-2017-0045 Background: Road traffi c noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD. Aim: This study aimed to explore the eff ect of residential RTN exposure on BP and renal function in patients with CVD from Plovdiv Province.
Materials and methods:We included 217 patients with ischemic heart disease and/or hypertension from three tertiary hospitals in the city of Plovdiv (March -May 2016). Patients' medical history, medical documentation, and medication regimen were reviewed, and blood pressure and anthropometric measurements were taken. Blood samples were analyzed for creatinine, total cholesterol, and blood glucose. Participants also fi lled a questionnaire. Glomerular fi ltration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. All participants were asked about their annoyance by diff erent noise sources at home, and those living in the city of Plovdiv (n = 132) were assigned noise map L den and L night exposure. The eff ects of noise exposure on systolic blood pressure (SBP), diastolic blood pressure (DBP), and estimated glomerular fi ltration rate (eGFR) were explored using mixed linear models. Results: Traffi c noise annoyance was associated with higher SBP in the total sample. The other noise indicators were associated with non-signifi cant elevation in SBP and reduction in eGFR. The eff ect of L den was more pronounced in patients with prior ischemic heart disease/stroke, diabetes, obesity, not taking Ca-channel blockers, and using solid fuel/gas at home. L night had stronger eff ect among those not taking statins, sleeping in a bedroom with noisy façade, having a living room with quiet façade, and spending more time at home. The increase in L den was associated with a signifi cant decrease in eGFR among men, patients with ischemic heart disease/stroke, and those exposed to lower air pollution. Regarding L night , there was signifi cant eff ect modifi cation by gender, diabetes, obesity, and time spent at home. In some subgroups, the eff ect of RTN was statistically signifi cant. Conclusions: Given that generic risk factors for poor progression of cardiovascular diseases cannot be controlled suffi ciently at individual level, environmental interventions to reduce residential noise exposure might result in some improvement in the management of blood pressure and kidney function in patients with CVD.