Indoor solid fuel use for heating and cooking with blood pressure and hypertension: A cross‐sectional study among middle‐aged and older adults in China

Abstract

A cross‐sectional study was conducted to investigate the impact of solid fuel use for heating and cooking on blood pressure (BP) and hypertension, using data from the China Health and Retirement Longitudinal Study (CHARLS). The primary fuels used for indoor heating and cooking were collected by questionnaires, respectively. Hypertension was defined based on self‐report of physician's diagnosis, and/or measured BP, and/or anti‐hypertensive medication use. Multivariate logistic regression models were constructed to assess the associations. Among 10 450 eligible participants, 68.2% and 57.2% used indoor solid fuel for heating and cooking, respectively. Compared with none/clean fuel users, solid fuel for heating was associated with elevated BP (adjusted β: 2.02, 95% CI: 1.04–3.01 for systolic BP; adjusted β: 1.36, 95% CI: 0.78–1.94 for diastolic BP) and increased risk of hypertension (adjusted odds ratio: 1.15, 95% CI: 1.03–1.29). The impact of indoor solid fuel for heating on BP was more evident in rural and north residents, and hypertensive patients. We did not detect any significant associations between solid fuel use for cooking and BP/hypertension. Indoor solid fuel use is prevalent in China, especially in the rural areas. Its negative impact on BP suggested that modernization of household fuel use may help to reduce the burden of hypertension in China.

Global magnitude and long‐term trend of ischemic heart disease burden attributed to household air pollution from solid fuels in 204 countries and territories, 1990–2019

“…Particulate matter in HAP is likely to cause oxidative stress, inflammation, abnormal lipid metabolism, and thrombosis in circulation, which will adversely affect endothelial function, and then induce atherosclerosis, the main pathological process behind IHD. [25][26][27][28][29] Exposure to air pollution was associated with higher blood pressure [30][31][32] and an imbalance of the autonomic control of the heart and reduced heart rate variability, [33][34][35] both of which were implicated as potential mediators of cardiovascular events.…”

Relationship Between Indoor Solid Fuel Use for Cooking with Blood Pressure and Hypertension Among the Elderly in China

“…A study of 3754 participants (≥ 45 years old) in China showed that people cooking with solid fuel were 1.15 times more likely to suffer from hypertension (OR = 1.15, 95% CI: 1.01, 1.31), and had an SBP 1.10 mmHg (95% CI: 0.48, 1.72), DBP 1.02 mmHg (95% CI: 0.61, 1.43), and MAP 1.03 mmHg (95% CI: 0.63, 1.43) higher than those who cooked with clean fuel(Deng et al, 2020). Another study of 10450 participants (≥65 years old) in China did not reveal any signi cant association between indoor solid fuel use for cooking and BP or hypertension(Lin et al, 2021). In addition, two Urban and Rural Epidemiology (PURE) studies considered participants aged 30-70 years.…”

“…Conversely, a study of 850 women aged > 40 years conducted in Pakistan found no association between hypertension and indoor solid fuel use (Fatmi et al, 2019). Overall, there is limited research concerning the use of solid fuels by the elderly (aged greater than 65 years), which is the population most at risk of raised BP, had an effect on BP and hypertension (Deng et al, 2020;Lin et al, 2021).…”

Mediating Factors Explaining the Associations between Solid Fuel Use and Self-Rated Health among Chinese Adults 65 Years and Older: A Structural Equation Modeling Approach

“…Previous studies have shown that the use of solid fuel seriously affected both the mental and the physical health of the elderly [ 5 , 7 , 8 , 9 , 10 , 11 ]. Many studies on middle-aged and elderly people have concluded that solid fuel use was significantly correlated with the health of elderly people, in terms of poor sleep quality [ 7 ], low cognitive function [ 8 ], high incidence of arthritis [ 12 ], high incidence of depression [ 5 ], and high incidence of hypertension [ 9 , 10 ]. In pathogenesis research, there is an increasing link between indoor air pollution and physical diseases from solid fuel [ 13 ].…”

“…The available evidence suggests that people with long-term exposure to indoor air pollution from cooking with solid fuel are more likely to have poor sleep quality [ 7 ], high risk of depressive symptoms [ 5 ], low cognitive function [ 8 ], high blood pressure [ 9 , 10 ], and low body mass index (BMI) [ 11 ], which might result in poor self-rated health as mediators in the elderly. Therefore, structural equation modeling (SEM) was used to evaluate the total, direct, and indirect effects of exposure to indoor air pollution from cooking with solid fuel on the self-rated health in a mediation analysis and to assess the indirect effect within these distinctive paths.…”