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Meta-Analysis
. 2014 Sep;122(9):896-905.
doi: 10.1289/ehp.1307725. Epub 2014 May 16.

Arterial Blood Pressure and Long-Term Exposure to Traffic-Related Air Pollution: An Analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

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Free PMC article
Meta-Analysis

Arterial Blood Pressure and Long-Term Exposure to Traffic-Related Air Pollution: An Analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Kateryna B Fuks et al. Environ Health Perspect. .
Free PMC article

Abstract

Background: Long-term exposure to air pollution has been hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country specific.

Objectives: We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hypertension in European populations.

Methods: We analyzed 15 population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). We modeled residential exposure to particulate matter and nitrogen oxides with land use regression using a uniform protocol. We assessed traffic exposure with traffic indicator variables. We analyzed systolic and diastolic BP in participants medicated and nonmedicated with BP-lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hypertension was defined as ≥ 140 mmHg systolic BP, or ≥ 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis.

Results: In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in nonmedicated participants [0.35 mmHg (95% CI: 0.02, 0.68) and 0.22 mmHg (95% CI: 0.04, 0.40) per 4,000,000 vehicles × m/day, respectively]. The estimated odds ratio (OR) for prevalent hypertension was 1.05 (95% CI: 0.99, 1.11) per 4,000,000 vehicles × m/day. Modeled air pollutants and BP were not clearly associated.

Conclusions: In this first comprehensive meta-analysis of European population-based cohorts, we observed a weak positive association of high residential traffic exposure with BP in nonmedicated participants, and an elevated OR for prevalent hypertension. The relationship of modeled air pollutants with BP was inconsistent.

Conflict of interest statement

The authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Cohort-specific and meta-analysis estimates of association of PM2.5 (A), absorbance PM2.5 (B), PMcoarse (C), and PM10 (D) with systolic BP and hypertension. Results are presented per given increments. I2 is a measure of heterogeneity between cohorts, and phet is a p-value for the Q-test of heterogeneity.
Figure 2
Figure 2
Cohort-specific and meta-analysis estimates of association of NO2 (A), NOx (B), traffic load at major road fragments (C), and traffic intensity at the nearest road (D) with systolic BP and hypertension. Results are presented per given increments. I2 is a measure of heterogeneity between cohorts, and phet is a p-value for the Q-test of heterogeneity.

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