Long-term associations of modeled and self-reported measures of exposure to air pollution and noise at residence on prevalent hypertension and blood pressure

Sci Total Environ. 2017 Sep 1;593-594:337-346. doi: 10.1016/j.scitotenv.2017.03.156. Epub 2017 Mar 27.


Air pollution, traffic noise and noise annoyance are suggested to be associated with hypertension and blood pressure (BP); however, the evidence remains inconsistent. Our study examined the long-term associations of modeled and self-reported measures of air pollution and traffic noise on prevalent hypertension and BP. We analyzed cross-sectional data from 2552 participants aged 31-72years from the KORA F4 (2006-2008) study conducted in the region of Augsburg, Germany. Land-use regression models were used to estimate residential long-term exposure to particulate matter <2.5μm (PM2.5), soot content of PM2.5 (PM2.5abs) and nitrogen dioxide (NO2). Road traffic noise levels at the facade of the dwellings were estimated for the participants' residences. Participants filled-in a questionnaire on noise annoyance and heavy traffic passing their residence. Linear and logistic regression models adjusting for confounders were used to assess the association between exposure measures and hypertension and BP. An interquartile increase in annual mean PM2.5 (1μg/m3) was significantly associated with 15% higher prevalence of hypertension, without (95% CI: 2.5; 28.0%) and with (95% CI: 0.7; 30.8%) adjustment for traffic noise. Diastolic blood pressure (DBP) was associated with air pollutants and traffic noise with percent increases in mean of 0.7 (95% CI: 0.2; 1.2), 0.6 (95% CI: 0.1; 1.1) and 0.3 (95% CI: 0.0; 0.7) for an interquartile increase in PM2.5 (1μg/m3) and PM2.5abs (0.2∗10-5/m), and 5dB(A) increase in 24-hour road traffic noise, respectively. Associations of PM2.5abs and NO2 with hypertension or DBP were stronger in men and diabetic individuals. No clear associations were seen with systolic BP or noise annoyance. In conclusion, self-reported measures of air pollution or noise did not perform better than the objective measures. Our findings provide further evidence for a link between air pollution, noise and cardiovascular disease and indicate a stronger association for men and diabetic individuals.

Keywords: Air pollution; Blood pressure; Hypertension; Noise annoyance; Road traffic noise; Traffic intensity.

MeSH terms

  • Adult
  • Aged
  • Air Pollution / analysis*
  • Blood Pressure*
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Environmental Exposure*
  • Female
  • Germany
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Nitrogen Dioxide / analysis
  • Noise*
  • Particulate Matter / analysis
  • Self Report


  • Particulate Matter
  • Nitrogen Dioxide