The association of hypertension and prehypertension with greenness and PM2.5 in urban environment

Jien-Wen Chien; Charlene Wu; Chang-Chuan Chan

doi:10.1016/j.scitotenv.2022.153526

The association of hypertension and prehypertension with greenness and PM_2.5 in urban environment

Sci Total Environ. 2022 May 15:821:153526. doi: 10.1016/j.scitotenv.2022.153526. Epub 2022 Jan 29.

Authors

Jien-Wen Chien¹, Charlene Wu², Chang-Chuan Chan³

Affiliations

¹ Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Pediatric Nephrology, Changhua Christian Children's Hospital, Changhua, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan.
² Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
³ Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Innovation and Policy Center for Population Health and Sustainable Environment (Population Health Research Center, PHRC), College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: ccchan@ntu.edu.tw.

PMID: 35101513
DOI: 10.1016/j.scitotenv.2022.153526

Abstract

Background: The interplay of air pollution and urban greenness on hypertension (HTN) is not fully understood.

Methods: We conducted a cross-sectional study to explore the role of greenness and PM_2.5 on HTN for 40,375 adult residents in the New Taipei City, Taiwan. Normalized Difference Vegetation Index (NDVI) defined greenness and land use regression derived exposures of PM_2.5 were used to calculate odds ratios (ORs) of HTN in logistic regression models and common OR of normal to stage 3 HTN in ordinal logistic regression models. Linear regression model was used to evaluate the association between NDVI and blood pressures, including systolic (SBP), diastolic (DBP) and mean (MBP) pressures. The mediation and moderation analysis were used to assess the mediation and moderation effect of PM_2.5 on the association between greenness and SBP.

Results: We found 37.3%, 21.4%, 8.2% and 2.7% of prehypertension and stage 1-3 hypertensions, respectively, for our study participants with annual PM_2.5 exposures of 10.96-43.59 μg/m³ living in an urban environment with NDVI within 500 m buffer ranging from -0.22 to 0.26. The ORs of HTN were 0.744 (95% CI: 0.698-0.793) for NDVI (quartile 4 vs. quartile 1) and 1.048 (1.012-1.085) for each IQR (8.69 μg/m³) increase in PM_2.5, respectively. The common OR of the higher level of 5 categories of BP was 1.1310 (1.241-1.383). With each IQR increase of NDVI (0.03), we found SBP, DBP and MBP were decreased by 0.78 mm Hg (-0.93-0.64), 0.52 mm Hg (-0.62-0.43) and 0.61 mm Hg (-0.71-0.51), respectively, in linear regression models. Stratified analysis found greenness effect was more prominent for people who are younger, female, never smoking, and without chronic diseases. PM_2.5 is moderated rather than mediated the association between greenness and SBP.

Conclusions: Greenness was associated with lower prevalence of prehypertension and all stages of HTN and this relationship was moderated by PM_2.5.

Keywords: Greenness; Hypertension; NDVI; PM(2.5); Prehypertension.

MeSH terms

Adult
Air Pollution* / analysis
Cross-Sectional Studies
Female
Humans
Hypertension* / epidemiology
Particulate Matter / analysis
Prehypertension*

Substances

Particulate Matter