Abstract
BackgroundResearch regarding the interaction of ambient air pollution and overweight on prehypertension is scarce. We aimed to test whether overweight modifies the association between long-term exposure to ambient air pollution and prehypertension in Chinese adults.MethodsA total of 16,188 Chinese adults, aged 18–74 years old, from 33 communities in 3 Northeastern Chinese cities were evaluated. Three-year average levels of particles with an aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxides (SO2), nitrogen dioxides (NO2), and ozone (O3) were calculated at monitoring stations. Generalized additive models and 2-level regression analyses were applied.ResultsWe observed significant interactions between air pollutants and overweight on prehypertension and blood pressure. The associations of PM10, SO2, NO2, and O3 with prehypertension were significant among overweight participants (Prevalence Rate Ratios (PRRs) per interquartile range (IQR) of air pollutants: 1.14–1.20), but not among normal weight participants (PRRs: 0.98–1.04). PM10, SO2, and O3 were significantly associated with systolic blood pressure (SBP), and the magnitudes of these associations were higher among overweight adults (increases in SBP per IQR of air pollutants: 1.82–4.53 mmHg) than those among normal weight adults (increases in SBP: 0.42–0.61 mmHg). For diastolic blood pressure (DBP), significant associations were mainly observed in overweight participants (increases in DBP: 0.80–1.63 mmHg). Further stratified analyses showed that all these interactions were stronger in women, the older, and participants living in areas with lower income levels or higher population density.ConclusionsBeing overweight may enhance the effects of ambient air pollution on prehypertension and blood pressure in Chinese adults.
Highlights
Research regarding the interaction of ambient air pollution and overweight on prehypertension is scarce
Overweight participants differed from normal weight participants in being older, men, Han nationality, having higher household income, doing more regular exercise, consuming fewer sugar-sweetened beverages, and having higher prehypertension prevalence (All p < 0.05), but with similar levels of educational attainment, smoking and drinking status, practice of controlling diet with low calorie and low fat intake, and family history of hypertension
In this large cross-sectional study of 15,477 Chinese adults, we found that being overweight modified the associations of long-term exposure to ambient air pollution (PM10, SO2, Nitrogen dioxide (NO2), and O3) with prehypertension and arterial blood pressure in adults
Summary
Research regarding the interaction of ambient air pollution and overweight on prehypertension is scarce. We aimed to test whether overweight modifies the association between long-term exposure to ambient air pollution and prehypertension in Chinese adults. There is mounting evidence that exposure to shortand long-term ambient air pollution may raise blood pressure levels and result in a pro-hypertensive response [7,8,9]. The mechanisms by which ambient air pollutants could contribute to the development of prehypertension might include promoting systemic inflammation and oxidative stress, instigating autonomic dysfunction, and triggering vascular endothelial dysfunction [7]. The pathophysiological mechanisms of inflammation and oxidative stress are shared with overweight/obesity in the hypothesized etiology of prehypertension [12]. Laboratory evidence has suggested that overweight/obesity can facilitate the effects of inhaled ambient air pollution on adipose inflammation [13]. Overweight/obese individuals may be more sensitive to the pro-hypertensive effects of ambient air pollutants
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