Document Type : Original Article(s)
- Alireza Khosravi 1
- Hamid Reza Rajabi 2
- Mehrbod Vakhshoori 3
- Katayoun Rabiei 4
- Sayed Mohsen Hosseini 5
- Asieh Mansouri 6
- Farshad Roghani-Dehkordi 7
- Jamshid Najafian 8
- Mojtaba Rahimi 9
- Tohid Jafari-Koshki 10
- Babak Sadeghian 11
- Mansour Shishehforoush 12
- Ahmadreza Lahijanzadeh 13
- Marzieh Taheri 14
- Nizal Sarrafzadegan 15
1 Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 General Practitioner, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 General Practitioner, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
5 Professor, Department of Biostatics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
6 Assistant Professor, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
7 Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
8 Associate Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
9 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10 Molecular Medicine Research Center, Department of Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
11 Central Laboratory and Air Pollution Monitoring, Isfahan Province Environmental Monitoring Center, Isfahan Department of Environment, Isfahan, Iran
12 Isfahan Disaster Management Office, Isfahan Governor Office, Isfahan, Iran
13 Khouzestan Department of Environment, Ahvaz, Iran
14 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
15 Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
BACKGROUND: The relation between air pollution and cardiovascular diseases (CVDs) risk factors, especially blood pressure (BP) levels, has been less frequently assessed. The aim of this study was evaluating the association between air pollutants of less than 2.5 µm [particulate matter (PM2.5)] and BP indices among individuals admitted with CVDs and pulmonary diseases.METHODS: This cross-sectional study was in context of air pollution associated with hospitalization and mortality of CVDs and respiratory diseases (CAPACITY) study. Data of 792 Iranian patients referring to two hospitals in Isfahan, Iran, for cardiovascular or respiratory problems from March 2011 to March 2012 were used for analysis. BP indices including systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were obtained from patients’ medical forms and mean PM2.5 concentrations during 24 hours prior to admission of each patient were obtained from Isfahan Department of Environment (DOE).RESULTS: Mean ± standard deviation (SD) of participants’ age were 62.5 ± 15.9 years. All BP indices on admission were significantly higher in women compared with men. Adjustment of all potential confounders including age, sex, temperature, wind speed, and dew point revealed that increasing one quartile in PM2.5 concentrations had been associated with 1.98 mmHg raising in SBP at the time of admission [95% confidence interval (CI) = 0.41-3.54, P = 0.010]. Women with cardiac diseases had higher all BP indices with increased PM2.5 concentration [SBP: β: 4.30, 95% CI = 0.90-7.70, P = 0.010; DBP: β: 1.89, 95% CI = 0.09-3.69, P = 0.040; MAP: β: 3.09, 95% CI = 0.68-5.51, P= 0.010, respectively).CONCLUSION: Our findings suggest that increasing PM2.5 concentration has been positively associated with raising SBP in total population and all BP indices among women with cardiac problems at admission time. Several comprehensive studies are required for confirming these relations.
- Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360(9349): 1903-13.
- Britton KA, Gaziano JM, Djousse L. Normal systolic blood pressure and risk of heart failure in US male physicians. Eur J Heart Fail 2009; 11(12): 1129-34.
- Pickering G. Hypertension. Definitions, natural histories and consequences. Am J Med 1972; 52(5): 570-83.
- Nowka MR, Bard RL, Rubenfire M, Jackson EA, Brook RD. Patient awareness of the risks for heart disease posed by air pollution. Prog Cardiovasc Dis 2011; 53(5): 379-84.
- World Health Organization. WHO urban outdoor air pollution database. Geneva, Switzerland: WHO; 2011.
- Franchini M, Mannucci PM. Particulate air pollution and cardiovascular risk: Short-term and long-term effects. Semin Thromb Hemost 2009; 35(7): 665-70.
- Brunekreef B, Holgate ST. Air pollution and health. Lancet 2002; 360(9341): 1233-42.
- Shah AS, Langrish JP, Nair H, McAllister DA, Hunter AL, Donaldson K. Global association of air pollution and heart failure: A systematic review and meta-analysis. Lancet 2013; 383(9897): 1039-48.
- Franchini M, Mannucci PM. Air pollution and cardiovascular disease. Thromb Res 2012; 129(3): 230-4.
- Zanobetti A, Canner MJ, Stone PH, Schwartz J, Sher D, Eagan-Bengston E, et al. Ambient pollution and blood pressure in cardiac rehabilitation patients. Circulation 2004; 110(15): 2184-9.
- Urch B, Silverman F, Corey P, Brook JR, Lukic KZ, Rajagopalan S, et al. Acute blood pressure responses in healthy adults during controlled air pollution exposures. Environ Health Perspect 2005; 113(8): 1052-5.
- Peters A, Liu E, Verrier RL, Schwartz J, Gold DR, Mittleman M, et al. Air pollution and incidence of cardiac arrhythmia. Epidemiology 2000; 11(1): 11-7.
- Rich DQ, Schwartz J, Mittleman MA, Link M, Luttmann-Gibson H, Catalano PJ, et al. Association of short-term ambient air pollution concentrations and ventricular arrhythmias. Am J Epidemiol 2005; 161(12): 1123-32.
- Yang BY, Markevych I, Bloom MS, Heinrich J, Guo Y, Morawska L, et al. Community greenness, blood pressure, and hypertension in urban dwellers: The 33 Communities Chinese Health Study. Environ Int 2019; 126: 727-34.
- Schwarze PE, Ovrevik J, Lag M, Refsnes M, Nafstad P, Hetland RB, et al. Particulate matter properties and health effects: consistency of epidemiological and toxicological studies. Hum Exp Toxicol 2006; 25(10): 559-79.
- Brook RD. Cardiovascular effects of air pollution. Clin Sci (Lond) 2008; 115(6): 175-87.
- Rabiei K, Hosseini SM, Sadeghi E, Jafari-Koshki T, Rahimi M, Shishehforoush M, et al. Air pollution and cardiovascular and respiratory disease: Rationale and methodology of CAPACITY study. ARYA Atheroscler 2017; 13(6): 264-73.
- Hicken MT, Dvonch JT, Schulz AJ, Mentz G, Max P. Fine particulate matter air pollution and blood pressure: The modifying role of psychosocial stress. Environ Res 2014; 133: 195-203.
- Liang R, Zhang B, Zhao X, Ruan Y, Lian H, Fan Z. Effect of exposure to PM2.5 on blood pressure: A systematic review and meta-analysis. J Hypertens 2014; 32(11): 2130-40.
- Auchincloss AH, Diez Roux AV, Dvonch JT, Brown PL, Barr RG, Daviglus ML, et al. Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-ethnic Study of Atherosclerosis (MESA). Environ Health Perspect 2008; 116(4): 486-91.
- Chen LH, Knutsen SF, Shavlik D, Beeson WL, Petersen F, Ghamsary M, et al. The association between fatal coronary heart disease and ambient particulate air pollution: Are females at greater risk? Environ Health Perspect 2005; 113(12): 1723-9.
- Kim CS, Hu SC. Regional deposition of inhaled particles in human lungs: Comparison between men and women. J Appl Physiol (1985) 1998; 84(6): 1834-44.
- Sorensen M, Daneshvar B, Hansen M, Dragsted LO, Hertel O, Knudsen L, et al. Personal PM2.5 exposure and markers of oxidative stress in blood. Environ Health Perspect 2003; 111(2): 161-6.
- Baccarelli A, Barretta F, Dou C, Zhang X, McCracken JP, Diaz A, et al. Effects of particulate air pollution on blood pressure in a highly exposed population in Beijing, China: A repeated-measure study. Environ Health 2011; 10: 108.
- Wu S, Deng F, Huang J, Wang H, Shima M, Wang X, et al. Blood pressure changes and chemical constituents of particulate air pollution: Results from the healthy volunteer natural relocation (HVNR) study. Environ Health Perspect 2013; 121(1): 66-72.
- Brook RD, Rajagopalan S, Pope CA 3rd, Brook JR, Bhatnagar A, Diez-Roux AV, et al. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation 2010; 121(21): 2331-78.
- Cakmak S, Dales R, Leech J, Liu L. The influence
- of air pollution on cardiovascular and pulmonary function and exercise capacity: Canadian Health Measures Survey (CHMS). Environ Res 2011; 111(8): 1309-12.
- Dai L, Koutrakis P, Coull BA, Sparrow D, Vokonas PS, Schwartz JD. Use of the adaptive lasso method to identify PM2.5 components associated with blood pressure in elderly men: The veterans affairs normative aging study. Environ Health Perspect 2016; 124(1): 120-5.
- Zhang H, Qian J, Zhao H, Wang J, Zhu H, Zhou Y, et al. A study of the association between atmospheric particulate matter and blood pressure in the population. Blood Press 2016; 25(3): 169-76.
- Yang BY, Qian Z, Howard SW, Vaughn MG, Fan SJ, Liu KK, et al. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis. Environ Pollut 2018; 235: 576-88.
- Pieters N, Koppen G, Van Poppel M, De Prins S, Cox B, Dons E, et al. Blood Pressure and Same-Day Exposure to Air Pollution at School: Associations with Nano-Sized to Coarse PM in Children. Environ Health Perspect 2015; 123(7): 737-42.