Long-term effects of PM2.5 components on hypertension: A national analysis in China

Shiyun Lv; Zhiwei Li; Haibin Li; Mengmeng Liu; Zhiyuan Wu; Siqi Yu; Binqiang Wu; Bo Gao; Lixin Tao; Yanxia Luo; Xia Li; Xiuhua Guo; Xiangtong Liu

doi:10.1016/j.envres.2023.115323

Long-term effects of PM_2.5 components on hypertension: A national analysis in China

Environ Res. 2023 Apr 1:222:115323. doi: 10.1016/j.envres.2023.115323. Epub 2023 Jan 18.

Authors

Shiyun Lv¹, Zhiwei Li¹, Haibin Li², Mengmeng Liu³, Zhiyuan Wu¹, Siqi Yu¹, Binqiang Wu⁴, Bo Gao¹, Lixin Tao¹, Yanxia Luo¹, Xia Li⁵, Xiuhua Guo⁶, Xiangtong Liu⁷

Affiliations

¹ School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
² Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
³ School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China.
⁴ School of Public Health, Capital Medical University, Beijing, China.
⁵ Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
⁶ School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China. Electronic address: statguo@ccmu.edu.cn.
⁷ School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. Electronic address: xiangtongl@ccmu.edu.cn.

PMID: 36681144
DOI: 10.1016/j.envres.2023.115323

Abstract

Background: Evidence is less about the associations between fine particulate matter (PM_2.5) components and hypertension. We aimed to examine the long-term effects of PM_2.5 components on prevalence of hypertension, diastolic blood pressure (DBP) and systolic blood pressure (SBP).

Methods: We included participants between March 1, and July 31, 2021, from 13 provinces in China. Geocoded residential address was used for exposure assignment. Mixed-effect regression was used to assess 3-year average concentrations of PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) on prevalence of hypertension, DBP and SBP with covariate-adjusted. SHapley Additive exPlanation was used to compare the contribution of PM_2.5 components to hypertension, DBP, and SBP. Sex and age subgroup were also analyzed.

Results: We enrolled a total of 113,159 participants aged ≥18 years. Long-term exposure to PM_2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) had associations with prevalence of hypertension, with the Odds Ratios and 95% confidence interval (CI) of 1.06 (95%CI: 1.03-1.09), 1.07 (95%CI: 1.04-1.09), 1.07 (95%CI: 1.04-1.10), 1.05 (95%CI: 1.01-1.08), 1.03 (95%CI: 1.00-1.06), and 1.03 (95%CI: 1.00-1.04), respectively. Effects of that except for black carbon on DBP with per interquartile upticks of concentration were 0.23 (95%CI: 0.11-0.35), 0.17 (95%CI: 0.04-0.29), 0.35 (95%CI: 0.21-0.48), 0.40 (95%CI: 0.28-0.52), and 0.25 (95%CI: 0.13-0.26), respectively. Ammonium was associated with SBP, corresponding to an increase of 0.18 (95%CI: 0.01-0.35). Males had higher risks of DBP (Z = 2.54-6.08, P < 0.001). Older people were substantially more affected by PM_2.5 and its components. Nitrate showed the highest contribution to hypertension, DBP and SBP compared with other components.

Conclusions: Long-term exposure to PM_2.5 and its components had adverse consequences on prevalence of hypertension, DBP and SBP, especially for males and older people. Nitrate contributed the highest to hypertension, DBP and SBP. Findings may have implications for pollution and hypertension control.

Keywords: Hypertension; PM(2.5) components; SHapley additive exPlanation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Air Pollutants* / toxicity
Air Pollution* / analysis
Blood Pressure
Carbon / analysis
China / epidemiology
Environmental Exposure / analysis
Humans
Hypertension* / epidemiology
Male
Nitrates / analysis
Particulate Matter / analysis

Substances

Air Pollutants
Nitrates
Particulate Matter
Carbon