TY - JOUR
T1 - Cross-sectional analysis of the association between personal exposure to household air pollution and blood pressure in adult women
T2 - Evidence from the multi-country Household Air Pollution Intervention Network (HAPIN) trial
AU - HAPIN investigators
AU - Nicolaou, Laura
AU - Underhill, Lindsay
AU - Hossen, Shakir
AU - Simkovich, Suzanne
AU - Thangavel, Gurusamy
AU - Rosa, Ghislaine
AU - McCracken, John P.
AU - Davila-Roman, Victor
AU - Fuentes, Lisa de las
AU - Quinn, Ashlinn K.
AU - Clark, Maggie
AU - Diaz, Anaite
AU - Pillarisetti, Ajay
AU - Steenland, Kyle
AU - Waller, Lance A.
AU - Jabbarzadeh, Shirin
AU - Peel, Jennifer L.
AU - Checkley, William
N1 - Funding Information:
The HAPIN trial was funded by the U.S. National Institutes of Health (cooperative agreement UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation [OPP1131279]. HAPIN Investigators: Vigneswari Aravindalochanan, Kalpana Balakrishnan, Gloriose Bankundiye, Dana Boyd Barr, Alejandra Bussalleu, Devan Campbell, Eduardo Canuz, Adly Castañaza, Howard H. Chang, William Checkley, Yunyun Chen, Marilú Chiang, Maggie L. Clark, Thomas F. Clasen, Rachel Craik, Victor G. Davila-Roman, Lisa de las Fuentes, Oscar De León, Anaité Diaz-Artiga, Ephrem Dusabimana, Juan Gabriel Espinoza, Sarada Garg, Ahana Ghosh, Sarah Hamid, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Ian Hennessee, Shakir Hossen, Penelope P. Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A. Johnson, Katherine Kearns, Miles A. Kirby, Jacob Kremer, Pattie Lenzen, Amy E. Lovvorn, Jane Mbabazi, Eric McCollum, John P. McCracken, Rachel Meyers, Lawrence Moulton, Alexie Mukeshimana, Krishnendu Mukhopadhyay, Bernard Mutariyani, Luke Naeher, Durairaj Natesan, Florien Ndagijimana, Laura Nicolaou, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Jennifer Peel, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Karthikeyan Dharmapuri Rajamani, Usha Ramakrishnan, Rengaraj Ramasami, Alexander Ramirez, Ghislaine Rosa, Joshua Rosenthal, P. Barry Ryan, Sudhakar Saidam, Sankar Sambandam, Jeremy A. Sarnat, Suzanne Simkovich, Sheela S. Sinharoy, Kirk R. Smith, Kyle Steenland, Damien Swearing, Gurusamy Thangavel, Lisa M. Thompson, Ashley Toenjes, Lindsay Underhill, Viviane Valdes, Lance A. Waller, Kendra N. Williams, Wenlu Ye, Bonnie N. Young.
Funding Information:
The HAPIN trial was funded by the U.S. National Institutes of Health (cooperative agreement UM1HL134590 ) in collaboration with the Bill & Melinda Gates Foundation [ OPP1131279 ].
Publisher Copyright:
© 2022
PY - 2022/11
Y1 - 2022/11
N2 - Elevated blood pressure (BP) is a leading risk factor for the global burden of disease. Household air pollution (HAP), resulting from the burning of biomass fuels, may be an important cause of elevated BP in resource-poor communities. We examined the exposure-response relationship of personal exposures to HAP —fine particulate matter (PM2.5), carbon monoxide (CO), and black carbon (BC) — with BP measures in women aged 40–79 years across four resource-poor settings in Guatemala, Peru, India and Rwanda. BP was obtained within a day of 24-h personal exposure measurements at baseline, when participants were using biomass for cooking. We used generalized additive models to characterize the shape of the association between BP and HAP, accounting for the interaction of personal exposures and age and adjusting for a priori identified confounders. A total of 418 women (mean age 52.2 ± 7.9 years) were included in this analysis. The interquartile range of exposures to PM2.5 was 42.9–139.5 μg/m3, BC was 6.4–16.1 μg/m3, and CO was 0.5–2.9 ppm. Both SBP and PP were positively associated with PM2.5 exposure in older aged women, achieving statistical significance around 60 years of age. The exact threshold varied by BP measure and PM2.5 exposures being compared. For example, SBP of women aged 65 years was on average 10.8 mm Hg (95% CI 1.0–20.6) higher at 232 μg/m3 of PM2.5 exposure (90th percentile) when compared to that of women of the same age with personal exposures of 10 μg/m3. PP in women aged 65 years was higher for exposures ≥90 μg/m3, with mean differences of 6.1 mm Hg (95% CI 1.8–10.5) and 9.2 mm Hg (95% CI 3.3–15.1) at 139 (75th percentile) and 232 μg/m3 (90th percentile) respectively, when compared to that of women of the same age with PM2.5 exposures of 10 μg/m3. Our findings suggest that reducing HAP exposures may help to reduce BP, particularly among older women.
AB - Elevated blood pressure (BP) is a leading risk factor for the global burden of disease. Household air pollution (HAP), resulting from the burning of biomass fuels, may be an important cause of elevated BP in resource-poor communities. We examined the exposure-response relationship of personal exposures to HAP —fine particulate matter (PM2.5), carbon monoxide (CO), and black carbon (BC) — with BP measures in women aged 40–79 years across four resource-poor settings in Guatemala, Peru, India and Rwanda. BP was obtained within a day of 24-h personal exposure measurements at baseline, when participants were using biomass for cooking. We used generalized additive models to characterize the shape of the association between BP and HAP, accounting for the interaction of personal exposures and age and adjusting for a priori identified confounders. A total of 418 women (mean age 52.2 ± 7.9 years) were included in this analysis. The interquartile range of exposures to PM2.5 was 42.9–139.5 μg/m3, BC was 6.4–16.1 μg/m3, and CO was 0.5–2.9 ppm. Both SBP and PP were positively associated with PM2.5 exposure in older aged women, achieving statistical significance around 60 years of age. The exact threshold varied by BP measure and PM2.5 exposures being compared. For example, SBP of women aged 65 years was on average 10.8 mm Hg (95% CI 1.0–20.6) higher at 232 μg/m3 of PM2.5 exposure (90th percentile) when compared to that of women of the same age with personal exposures of 10 μg/m3. PP in women aged 65 years was higher for exposures ≥90 μg/m3, with mean differences of 6.1 mm Hg (95% CI 1.8–10.5) and 9.2 mm Hg (95% CI 3.3–15.1) at 139 (75th percentile) and 232 μg/m3 (90th percentile) respectively, when compared to that of women of the same age with PM2.5 exposures of 10 μg/m3. Our findings suggest that reducing HAP exposures may help to reduce BP, particularly among older women.
KW - Blood pressure
KW - Cardiovascular diseases
KW - Household air pollution
KW - Low- and middle-income countries
UR - http://www.scopus.com/inward/record.url?scp=85136625477&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2022.114121
DO - 10.1016/j.envres.2022.114121
M3 - Article
C2 - 36029836
AN - SCOPUS:85136625477
VL - 214
JO - Environmental Research
JF - Environmental Research
SN - 0013-9351
M1 - 114121
ER -