Air Pollution Exposures and Risk of High Blood Pressure in Diabetes Mellitus Patients, China: A Retrospective Cohort Study

Abstract

Background: Air pollution exposures have been associated with hypertension, but limited studies have examined the associations in diabetes mellitus patients.Objectives: We aimed to examine the associations of exposure to air pollution with risk of hypertension in diabetes mellitus patients.Methods: We identified hypertension cases from hospital records among patients who were previously diagnosed as diabetes mellitus from January 2013 to May 2017.We used generalized additional models to estimate adverse effects of air pollution on systolic/diastolic blood pressure in diabetes patients.Results: A total of 2,050 patients were enrolled in this study. A 10μg/m3 increase in PM2.5, PM10, SO2, and O3 exposure was associated with an increased risk of higher systolic blood pressure[D1] level (risk ratio (RR) =1.001; 95% confidence interval (CI):1.000, 1.002; RR =1.001; 95%CI: 1.000, 1.002; RR =1.004; 95%CI: 1.001, 1.006). Significant associations were observed with fasting blood glucose(fbg) ≥7.0mmol/L, overweight/ obesity, and younger age. Little evidence has been observed for the associations between particulate matter (PM), SO2 and O3 exposure and diastolic blood pressure in present study.Conclusions: In our study, diabetes patients were at increased risk for higher blood pressure when exposed to higher residential PM and SO2. Individuals with higher BMI, younger age, and FBG≥7.0mmol/L were more susceptible to ambient air pollution.