• 1 Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA; School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada. Electronic address:
  • 2 School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
  • 3 Dubai Health Authority, United Arab Emirates
  • 4 College of Medicine, King Saud University, Saudi Arabia
  • 5 Dante Pazzanese Institute of Cardiology and University of Santo Amaro, São Paulo, Brazil
  • 6 Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
  • 7 Independent University, Bangladesh
  • 8 Philippine General Hospital, Manila, Philippines
  • 9 Eternal Heart Care Centre and Research Institute, Jaipur, India
  • 10 Departments of Community Health Sciences and Medicine, The Aga Khan University, Karachi, Pakistan
  • 11 Faculty of Medicine, University Kebangsaan, Kuala Lumpur, Malaysia
  • 12 Cardiovascular Research Institute, Isfahan University of Medical Sciences, Iran
  • 13 Advocate Research Institute, Advocate Health Care, Downers Grove, IL, USA
  • 14 Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
  • 15 School of Public Health, PGIMER, Chandigarh, India
  • 16 Universidad de La Frontera, Temuco, Chile
  • 17 Simon Fraser University, Vancouver, Canada
  • 18 Research Institute FOSCAL and Masira Institute, UDES, Bucaramanga, Colombia
  • 19 Madras Diabetes Research Foundation, Chennai, India
  • 20 Université Laval and Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
  • 21 School of Public Health, University of the Western Cape, Bellville, South Africa
  • 22 University of Gothenburg and Sahlgrenska University Hospital Gothenburg, Sweden
  • 23 Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
  • 24 Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Turkey
  • 25 Center for Disease Control and Prevention, Yunnan, China
  • 26 Queen's University, Kingston, Ontario, Canada
  • 27 UCSI University, Kuala Lumpur, Malaysia & Universiti Teknologi MARA, Selayang, Malaysia
  • 28 Department of Otolaryngology Head and Neck Surgery, Medical University, Wrocław, Poland
  • 29 School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
Environ Pollut, 2020 Jul;262:114197.
PMID: 32146361 DOI: 10.1016/j.envpol.2020.114197


Exposure to air pollution has been linked to elevated blood pressure (BP) and hypertension, but most research has focused on short-term (hours, days, or months) exposures at relatively low concentrations. We examined the associations between long-term (3-year average) concentrations of outdoor PM2.5 and household air pollution (HAP) from cooking with solid fuels with BP and hypertension in the Prospective Urban and Rural Epidemiology (PURE) study. Outdoor PM2.5 exposures were estimated at year of enrollment for 137,809 adults aged 35-70 years from 640 urban and rural communities in 21 countries using satellite and ground-based methods. Primary use of solid fuel for cooking was used as an indicator of HAP exposure, with analyses restricted to rural participants (n = 43,313) in 27 study centers in 10 countries. BP was measured following a standardized procedure and associations with air pollution examined with mixed-effect regression models, after adjustment for a comprehensive set of potential confounding factors. Baseline outdoor PM2.5 exposure ranged from 3 to 97 μg/m3 across study communities and was associated with an increased odds ratio (OR) of 1.04 (95% CI: 1.01, 1.07) for hypertension, per 10 μg/m3 increase in concentration. This association demonstrated non-linearity and was strongest for the fourth (PM2.5 > 62 μg/m3) compared to the first (PM2.5 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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