Hypertension Prevalence and Living Conditions Related to Air Pollution: Results of a National Epidemiological Study in Lebanon

Environ Sci Pollut Res Int. 2018 Apr;25(12):11716-11728. doi: 10.1007/s11356-018-1411-x. Epub 2018 Feb 13.


Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

Keywords: Air pollution; Cumulative risk; Developing country; Hypertension; Indoor; Living conditions; Outdoor.

MeSH terms

  • Adult
  • Aged
  • Air Pollutants / analysis
  • Air Pollutants / toxicity*
  • Air Pollution, Indoor* / analysis
  • Cross-Sectional Studies
  • Environmental Exposure* / analysis
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology*
  • Lebanon / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Social Conditions*


  • Air Pollutants