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Long-term exposure to ambient fine particulate pollution (PM2.5) has been associated with cardiovascular diseases. Hypertension, a major risk factor for cardiovascular diseases, has also been hypothesized to be linked to PM2.5. However, epidemiological evidence has been mixed. We examined long-term association between ambient PM2.5 and hypertension and blood pressure. We interviewed 12,665 participants aged 50 years and older and measured their blood pressures. Annual average PM2.5 concentrations were estimated for each community using satellite data. We applied two-level logistic regression models to examine the associations, and estimated hypertension burden attributable to ambient PM2.5. For each 10 μg/m3 increase in ambient PM2.5, the adjusted odds ratio of hypertension was 1.14 (95% confidence interval, 1.07, 1.22). Stratified analyses found that overweight and obesity could enhance the association, and consumption of fruit was associated with lower risk. We further estimated that 11.75% (95% confidence interval: 5.82%, 18.53%) of the hypertension cases (corresponding to 914, 95% confidence interval: 453, 1442 cases) could be attributable to ambient PM2.5 in the study population. Findings suggest that long-term exposure to ambient PM2.5 might be an important risk factor of hypertension, and is responsible for significant hypertension burden in adults in China. A higher consumption of fruit may mitigate, while overweight and obesity could enhance this effect.

Little is known about the joint mental health effects of air pollution and tobacco smoking in low- and middle-income countries.To investigate the effects of exposure to ambient fine particulate matter pollution (PM) and smoking and their combined (interactive) effects on depression.Multilevel logistic regression analysis of baseline data of a prospective cohort study ( = 41 785). The 3-year average concentrations of PM were estimated using US National Aeronautics and Space Administration satellite data, and depression was diagnosed using a standardised questionnaire. Three-level logistic regression models were applied to examine the associations with depression.The odds ratio (OR) for depression was 1.09 (95% C11.01-1.17) per 10 μg/m increase in ambient PM, and the association remained after adjusting for potential confounding factors (adjusted OR = 1.10, 95% CI 1.02-1.19). Tobacco smoking (smoking status, frequency, duration and amount) was also significantly associated with depression. There appeared to be a synergistic interaction between ambient PM and smoking on depression in the additive model, but the interaction was not statistically significant in the multiplicative model.Our study suggests that exposure to ambient PM may increase the risk of depression, and smoking may enhance this effect.

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