Effect of air pollutants on ambulatory blood pressure

N Soldevila; E Vinyoles; A Tobias; M Á Muñoz-Pérez; M Gorostidi; A de la Sierra

doi:10.1016/j.hipert.2023.01.001

Effect of air pollutants on ambulatory blood pressure

Hipertens Riesgo Vasc. 2023 Jul-Sep;40(3):119-125. doi: 10.1016/j.hipert.2023.01.001. Epub 2023 Sep 23.

Authors

N Soldevila¹, E Vinyoles², A Tobias³, M Á Muñoz-Pérez⁴, M Gorostidi⁵, A de la Sierra⁶

Affiliations

¹ La Mina Primary Care Health Centre, University of Barcelona, Spain. Electronic address: nsoldevila.cc.ics@gencat.cat.
² La Mina Primary Care Health Centre, University of Barcelona, Spain.
³ The Spanish National Research Council (CSIC Barcelona), Spain.
⁴ Cardiovascular Research Group (GRECAP), Catalan Health Institute, Barcelona, Spain.
⁵ Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
⁶ Hypertension Unit, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain.

PMID: 37748946
DOI: 10.1016/j.hipert.2023.01.001

Abstract

Background and methodology: Air pollutants have a significant impact on public health. The aim of the study was to find out the relationship between ambulatory blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM) and the atmospheric pollutants that are measured regularly (PM₁₀, PM_2.5, NO₂ and SO₂). An observational study of temporal and geographic measurements of individual patients (case-time series design) was carried out in Primary Care Centres and Hypertension Units in the Barcelona metropolitan area. We included 2888 hypertensive patients≥18 years old, untreated, with a first valid ABPM performed between 2005 and 2014 and with at least one air pollution station within a radius of <3km.

Results and conclusions: The mean age was 54.3 (SD 14.6) years. 50.1% were women and 16.9% of the sample were smokers. Mean 24-h blood pressure (BP) was 128.0 (12.7)/77.4 (9.7) mmHg. After adjusting for mean ambient temperature and different risk factors, a significant association was found between ambulatory diastolic BP (DBP) and PM₁₀ concentrations the day before ABPM. For each increase of 10μg/m³ of PM₁₀, an increase of 1.37mmHg 24-h DBP and 1.48mmHg daytime DBP was observed. No relationship was found between PM_2.5, NO₂ and SO₂ and ambulatory BP, nor between any pollutant and clinical BP. The concentration of PM₁₀ the day before the ABPM is significantly associated with an increase in 24-h DBP and daytime DBP.

Keywords: 24h ABPM; Air pollution; Atención primaria; Contaminación atmosférica; Environmental temperature; MAPA 24h; Primary care; Temperatura ambiental.