Abstract
Exposure to air particulate matter has been linked with hypertension and blood pressure levels. The metabolic risks of air pollution could vary according to the specific characteristics of each area, and has not been sufficiently evaluated in Spain. We analyzed 1103 individuals, participants in a Spanish nationwide population based cohort study (di@bet.es), who were free of hypertension at baseline (2008–2010) and completed a follow-up exam of the cohort (2016–2017). Cohort participants were assigned air pollution concentrations for particulate matter < 10 μm (PM10) and < 2.5 μm (PM2.5) during follow-up (2008–2016) obtained through modeling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). Mean and SD concentrations of PM10 and PM2.5 were 20.17 ± 3.91 μg/m3 and 10.83 ± 2.08 μg/m3 respectively. During follow-up 282 cases of incident hypertension were recorded. In the fully adjusted model, compared with the lowest quartile of PM10, the multivariate weighted ORs (95% CIs) for developing hypertension with increasing PM10 exposures were 0.82 (0.59–1.14), 1.28 (0.93–1.78) and 1.45 (1.05–2.01) in quartile 2, 3 and 4 respectively (p for a trend of 0.003). The corresponding weighted ORs according to PM2.5 exposures were 0.80 (0.57–1.13), 1.11 (0.80–1.53) and 1.48 (1.09–2.00) (p for trend 0.004). For each 5-μg/m3 increment in PM10 and PM2.5 concentrations, the odds for incident hypertension increased 1.22 (1.06–1.41) p = 0.007 and 1.39 (1.07–1.81) p = 0.02 respectively. In conclusion, our study contributes to assessing the impact of particulate pollution on the incidence of hypertension in Spain, reinforcing the need for improving air quality as much as possible in order to decrease the risk of cardiometabolic disease in the population.
Highlights
The World Health Organization (WHO) has identified air pollution as the largest single environmental health risk worldwide with outdoor air pollution accounting for more than 4.2 million deaths every year[1]
Subgroup analysis showed that the association was consistent across strata of sex, age, MedScore adherence, physical activity, smoking status, alcohol intake and BMI without any significant effect modification by these factors (Fig. 1). In this nationwide cohort of Spanish non-hypertensive adults we found a positive association between Particulate matter (PM) concentrations and the incidence of hypertension after a mean follow-up of 7.4 years
To the best of our knowledge, this report provides the first data about the impact of air pollutants on hypertension in Spain from a National study perspective, whereas previous evidence had been limited to local studies from Northeast S pain[18], included in multicenter studies[12]
Summary
The World Health Organization (WHO) has identified air pollution as the largest single environmental health risk worldwide with outdoor air pollution accounting for more than 4.2 million deaths every year[1]. Residential estimates of outdoor air pollution concentrations during follow-up across the study sample were relatively low, with mean and SD concentrations of PM10 and PM2.5 of 20.17 ± 3.91 μg/m3 and 10.83 ± 2.08 μg/m3 respectively (Table 2), again concordant with the background estimates for the Spanish population.
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