Residential greenness attenuated association of long-term air pollution exposure with elevated blood pressure: Findings from polluted areas in Northern China

Abstract

BackgroundEvidence on the hypertensive effects of long-term air pollutants exposure are mixed, and the joint hypertensive effects of air pollutants are also unclear. Sparse evidence exists regarding the modifying role of residential greenness in such effects.MethodsA cross-sectional study was conducted in typically air-polluted areas in northern China. Particulate matter with diameter < 1 μm (PM1), particulate matter with diameter < 2.5 μm (PM2.5), particulate matter with diameter < 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were predicted by space–time extremely randomized trees model. We used the Normalized Difference Vegetation Index (NDVI) to reflect residential green space. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were examined. We also calculated the pulse pressure (PP) and mean arterial pressure (MAP). Generalized additive model and quantile g-computation were, respectively, conducted to investigate individual and joint effects of air pollutants on blood pressure. Furthermore, beneficial effect of NDVI and its modification effect were explored.ResultsLong-term air pollutants exposure was associated with elevated DBP and MAP. Specifically, we found a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 2.36% (95% CI: 0.97, 3.76), 1.51% (95% CI: 0.70, 2.34), and 3.54% (95% CI: 1.55, 5.56) increase in DBP; a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 1.84% (95% CI: 0.74, 2.96), 1.17% (95% CI: 0.52, 1.83), and 2.43% (95% CI: 0.71, 4.18) increase in MAP. Air pollutants mixture (one quantile increase) was positively associated with increased values of DBP (8.22%, 95% CI: 5.49, 11.02) and MAP (4.15%, 95% CI: 2.05, 6.30), respectively. These identified harmful effect of air pollutants mainly occurred among these lived with low NDVI values. And participants aged ≥50 years were more susceptible to the harmful effect of PM2.5 and PM10 compared to younger adults.ConclusionsOur study indicated the harmful effect of long-term exposure to air pollutants and these effects may be modified by living within higher green space place. These evidence suggest increasing residential greenness and air pollution control may have simultaneous effect on decreasing the risk of hypertension.

Association of SO2/CO exposure and greenness with high blood pressure in children and adolescents: A longitudinal study in China

“…Our findings were consistent with most previous relevant studies ( 6 , 27 , 39 ). For instance, a cross-sectional study of around 10,000 children from seven northeastern cities in China found that higher greenness levels around schools significantly lower the risk of childhood HBP ( 42 ).…”

“…The blood pressure in different subgroups may be influenced by growth and development characteristics, for example, sex-related differences in hormone secretion, age-related differences in puberty timing ( 31 ), obesity-related differences in endocrine regulation/insulin resistance, and environment sensitivity ( 32 , 33 ). Previous findings on these subgroups' sensitivity to SO 2 , CO and greenness exposure are limited ( 18 , 27 ) and therefore further validation and supplementation are still needed.…”

“…Few of them focused on SO 2 and CO. A cross-sectional study in Northern China found a 10-μg/m 3 increase in SO 2 was responsible for a 2.43% increase in mean arterial pressure among adults. These identified harmful effects of SO 2 mainly occurred among people who lived in low-greenness environments ( 27 ). Subgroup analysis of greenness may provide a concise illustration of the role of greenness on health outcomes.…”

Long-term Exposure to Ambient Ozone at Workplace is Positively and Non-linearly Associated with Incident Hypertension and Blood Pressure: Longitudinal Evidence from the Beijing-Tianjin-Hebei Medical Examination Cohort

“…Although blood pressure levels are a better measure of the health risks associated with blood pressure than hypertensive status, only a few studies have evaluated the effect of long-term O 3 exposure on blood pressure levels and the results were inclusive [14,39]. Moreover, the longitudinal effects of long-term ozone exposure on blood pressure indicators have been rarely documented [39].…”

“…Due to the very limited number of association studies between long-term O 3 exposure and hypertension, even a systematic review could not reach a robust conclusion on the plausibility of its association with hypertension [4]. In addition, most of the existing studies are limited by their cross-sectional design [10][11][12]14]. The only two cohort studies were both conducted in speci c populations, African American population with a high (56%) prevalence of hypertension [13] and American black women [15].…”