Household air pollution from biomass fuel use affects three billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity (FVC) were conducted to evaluate for effect modification. Data from 1004 individuals (mean age 55.3 years, 51.7% female) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio 5.0, 95% CI 2.6 to 9.9) and hypertension (adjusted relative risk ratio 3.5, 95% CI 1.7 to 7.0). Biomass fuel users had a higher SBP (7.01 mmHg, 95% CI 4.4 to 9.6) and a higher DBP (5.9 mmHg, 95% CI 4.2 to 7.6) when compared to nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted FVC for either SBP or DBP. Biomass fuel use was associated with an increased risk of hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.

No abstract

ObjectiveWe assessed the hypothesis that metabolic syndrome is associated with adverse changes in cardiac structure and function in participants of the Echocardiographic Study of Latinos (Echo-SOL).MethodsNon-diabetic Echo-SOL participants were included in this cross-sectional analysis. Metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. Survey multivariable linear regression analyses using sampling weights were used adjusting for multiple potential confounding variables. Additional analysis was stratified according to the presence/absence of obesity (body mass index (BMI) ≥25 kg/m2) and the presence/absence of metabolic syndrome.ResultsWithin Echo-SOL, 1260 individuals met inclusion criteria (59% female; mean age 55.2 years). Compared with individuals without metabolic syndrome, those with metabolic syndrome had lower medial and lateral E′ velocities (−0.4 cm/s, (SE 0.1), p=0.0002; −0.5 cm/s (0.2), p=0.02, respectively), greater E/E′ (0.5(0.2), p=0.01) and worse two-chamber left ventricular longitudinal strain (0.9%(0.3), p=0.009), after adjusting for potential confounding variables. Increased left ventricular mass index (9.8 g/m2 (1.9), p<0.0001 and 7.5 g/m2 (1.7), p<0.0001), left ventricular end-diastolic volume (11.1 mL (3.0), p=0.0003 and 13.3 mL (2.7), p<0.0001), left ventricular end-systolic volume (5.0 mL (1.4), p=0.0004 and 5.7 mL (1.3) p<0.0001) and left ventricular stroke volume (10.2 mL (1.8), p<0.0001 and 13.0 mL (2.0), p<0.0001) were observed in obese individuals with and without metabolic syndrome compared with individuals with normal weight without metabolic syndrome. In sensitivity analyses, individuals with normal weight (BMI <25 kg/m2) and metabolic syndrome had worse left ventricular global longitudinal strain (2.1%(0.7), p=0.002) and reduced left ventricular ejection fraction (−3.5%(1.4), p=0.007) compared with normal-weight individuals without metabolic syndrome.ConclusionsIn a sample of US Hispanics/Latinos metabolic syndrome was associated with worse left ventricular systolic and diastolic function. Adverse changes in left ventricular size and function were observed in obese individuals with and without metabolic syndrome but decreased left ventricular function was also present in normal-weight individuals with metabolic syndrome.