Household air pollution and measures of blood pressure, arterial stiffness and central haemodynamics

Abstract

Objective: We evaluated the exposure-response associations between personal exposure to air pollution from biomass stoves and multiple vascular and haemodynamic parameters in rural Chinese women.

Methods: We analysed the baseline information from a longitudinal study in southwestern China. Women's brachial and central blood pressure and pulse pressure, carotid-femoral pulse wave velocity and augmentation index, and their 48-hour personal exposures to fine particulate matter (PM_2.5) and black carbon were measured in summer and winter. We evaluated the associations between exposure to air pollution and haemodynamic parameters using mixed-effects regression models adjusted for known cardiovascular risk factors.

Results: Women's (n=205, ages 27-86 years) exposures to PM_2.5 and black carbon ranged from 14 µg/m³ to 1405 µg/m³ and 0.1-121.8 µg/m³, respectively. Among women aged ≥50 years, increased PM_2.5 exposure was associated with higher systolic (brachial: 3.5 mm Hg (P=0.05); central: 4.4 mm Hg (P=0.005)) and diastolic blood pressure (central: 1.3 mm Hg (P=0.10)), higher pulse pressure (peripheral: 2.5 mm Hg (P=0.05); central: 2.9 mm Hg (P=0.008)) and lower peripheral-central pulse pressure amplification (-0.007 (P=0.04)). Among younger women, the associations were inconsistent in the direction of effect and not statistically significant. Increased PM_2.5 exposure was associated with no difference in pulse wave velocity and modestly higher augmentation index though the CI included zero (1.1%; 95% CI -0.2% to 2.4%). Similar associations were found for black carbon exposure.

Conclusions: Exposure to household air pollution was associated with higher blood pressure and central haemodynamics in older Chinese women, with no associations observed with pulse wave velocity.

Keywords: cardiac risk factors and prevention; epidemiology; global health; peripheral vascular disease.