The impact of PM2.5 on children's blood pressure growth curves: A prospective cohort study

Xiaohua Liang; Jingyu Chen; Xizhou An; Fangchao Liu; Fengchao Liang; Xian Tang; Ping Qu

doi:10.1016/j.envint.2021.107012

The impact of PM2.5 on children's blood pressure growth curves: A prospective cohort study

Environ Int. 2022 Jan:158:107012. doi: 10.1016/j.envint.2021.107012. Epub 2021 Dec 3.

Authors

Xiaohua Liang¹, Jingyu Chen², Xizhou An², Fangchao Liu³, Fengchao Liang⁴, Xian Tang², Ping Qu²

Affiliations

¹ Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China. Electronic address: xiaohualiang@hospital.cqmu.edu.cn.
² Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
³ Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
⁴ School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China.

PMID: 34991268
DOI: 10.1016/j.envint.2021.107012

Abstract

Objective: The aim of this study was to explore the association between exposure to particulate matter with an aerodynamic diameter of 2.5 mm or less (PM2.5) and blood pressure (BP) levels in children and adolescents and to illustrate the impact of PM2.5 levels on BP growth curves in a cohort study.

Methods: A longitudinal study was designed and included 4303 children (7617 BP measurements) living in the selected areas, and evaluations were conducted in 2014-2015 (visit 1) and followed up in 2019 (visit 2). Two-stage stratified cluster sampling was used to include urban-rural areas. A mixed linear regression model and mixed logistic regression model were used to analyze the effect of PM2.5 exposure on BP and the incidence of prehypertension and hypertension in children.

Results: After adjusting for covariates, systolic blood pressure (SBP) (2.21 (95% CIs: 0. 81, 3.62), mmHg), diastolic blood pressure (DBP) (1.92 (95% CIs: 0.74, 3.11), mmHg), mean arterial pressure (MAP) (2.03 (95% CIs: 0.89, 3.17), mmHg) and heart rate (HR) (2.24 (95% CIs: 0.11, 4.37), beats/min) increased significantly in the fourth quartile of PM2.5 exposure levels compared with the first quartile (all P < 0.01). In addition, long-term exposure to PM2.5 was significantly positively correlated with SBP, DBP and MAP, and the effect was more notable in urban areas than that in rural areas. Moreover, the risk of prehypertension and hypertension incidence increased by 1.17 (95% CIs: 1.03, 1.33) fold with a one-quartile increase in PM2.5 exposure. The long-term effects of annual mean PM2.5 exposure on SBP, DBP and MAP were significant from pregnancy to 7, 3 and 4 years of age, respectively.

Conclusion: Long-term exposure to PM2.5 was positively associated with growth curves of hemodynamics indexed from pregnancy to childhood and adolescence, and the effect was more significant in urban areas than in rural areas.

Keywords: Air pollution; Blood pressure; Children and adolescents; Growth curve; Urban-rural areas.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / analysis
Air Pollution* / statistics & numerical data
Blood Pressure
Child
Cohort Studies
Environmental Exposure / analysis
Environmental Exposure / statistics & numerical data
Female
Humans
Hypertension* / epidemiology
Longitudinal Studies
Particulate Matter / analysis
Pregnancy
Prospective Studies

Substances

Air Pollutants
Particulate Matter