Relationship between daily exposure to biomass fuel smoke and blood pressure in high-altitude Peru

Melissa Burroughs Peña, Karina M Romero, Eric J Velazquez, Victor G Davila-Roman, Robert H Gilman, Robert A Wise, J Jaime Miranda, William Checkley, Melissa Burroughs Peña, Karina M Romero, Eric J Velazquez, Victor G Davila-Roman, Robert H Gilman, Robert A Wise, J Jaime Miranda, William Checkley

Abstract

Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥ 35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6-9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7-7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4-9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2-7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.

Keywords: Latin America; air pollution; blood pressure; global health; health status disparities; indoor air pollution; rural health.

Conflict of interest statement

Disclosure

The authors disclose no conflicts of interest.

© 2015 American Heart Association, Inc.

Figures

Figure 1
Figure 1
Differences in systolic blood pressure and diastolic blood pressure in daily biomass fuel users and non-users stratified by quartiles of percent predicted forced vital capacity. Panels A shows unadjusted differences for systolic blood pressure. Panel B shows unadjusted differences for diastolic blood pressure.

References

    1. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–2260.
    1. Rajagopalan S, Brook R. Indoor-outdoor air pollution continuum and CVD burden: An opportunity for improving global health. Global Heart. 2012;7:207–213.
    1. Mortimer K, Gordon SB, Jindal SK, Accinelli RA, Balmes J, Martin WJ., 2nd Household air pollution is a major avoidable risk factor for cardiorespiratory disease. Chest. 2012;142:1308–1315.
    1. Shah AS, Langrish JP, Nair H, McAllister DA, Hunter AL, Donaldson K, Newby DE, Mills NL. Global association of air pollution and heart failure: a systematic review and meta-analysis. Lancet. 2013;382:1039–1048.
    1. Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SC, Jr, Tager I Expert Panel on P, Prevention Science of the American Heart A. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004;109:2655–2671.
    1. Brook RD, Rajagopalan S, Pope CA, 3rd, et al. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation. 2010;121:2331–2378.
    1. Milojevic A, Wilkinson P, Armstrong B, Bhaskaran K, Smeeth L, Hajat S. Short-term effects of air pollution on a range of cardiovascular events in England and Wales: case-crossover analysis of the MINAP database, hospital admissions and mortality. Heart. 2014;100:1093–1098.
    1. Lee MS, Hang JQ, Zhang FY, Dai HL, Su L, Christiani DC. In-home solid fuel use and cardiovascular disease: a cross-sectional analysis of the Shanghai Putuo study. Environ Health. 2012;11:18.
    1. Dutta A, Ray MR. Prevalence of hypertension and pre-hypertension in rural women: a report from the villages of West Bengal, a state in the eastern part of India. Aust J Rural Health. 2012;20:219–225.
    1. Baumgartner J, Schauer JJ, Ezzati M, Lu L, Cheng C, Patz JA, Bautista LE. Indoor air pollution and blood pressure in adult women living in rural China. Environ Health Perspect. 2011;119:1390–1395.
    1. Dutta A, Ray MR, Banerjee A. Systemic inflammatory changes and increased oxidative stress in rural Indian women cooking with biomass fuels. Toxicol Appl Pharmacol. 2012;261:255–262.
    1. Jacobs DR, Yatsuya H, Hearst MO, Thyagarajan B, Kalhan R, Rosenberg S, Smith LJ, Barr RG, Duprez DA. Rate of decline of forced vital capacity predicts future arterial hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Hypertension. 2012;59:219–225.
    1. Duprez DA, Hearst MO, Lutsey PL, Herrington DM, Ouyang P, Barr RG, Bluemke DA, McAllister D, Carr JJ, Jacobs DR. Associations among Lung Function, Arterial Elasticity and Circulating Endothelial and Inflammation Markers: the Multi-Ethnic Study of Atherosclerosis. Hypertension. 2013;61:542–548.
    1. Margretardottir OB, Thorleifsson SJ, Gudmundsson G, Olafsson I, Benediktsdottir B, Janson C, Buist AS, Gislason T. Hypertension, Systemic Inflammation and Body Weight in Relation to Lung Function Impairment--An Epidemiological Study. COPD. 2009;6:250–255.
    1. Schnabel E, Karrasch S, Schulz H, Glaser S, Meisinger C, Heier M, Peters A, Wichmann HE, Behr J, Huber RM, Heinrich J. High blood pressure, antihypertensive medication and lung function in a general adult population. Respir Res. 2011;12:50.
    1. Miranda JJ, Bernabe-Ortiz A, Smeeth L, Gilman RH, Checkley W Group CCS. Addressing geographical variation in the progression of non-communicable diseases in Peru: the CRONICAS cohort study protocol. BMJ Open. 2012;2:e000610.
    1. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–338.
    1. Jones DW, Hall JE. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and evidence from new hypertension trials. Hypertension. 2004;43:1–3.
    1. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159:179–187.
    1. Hallal PC, Gomez LF, Parra DC, Lobelo F, Mosquera J, Florindo AA, Reis RS, Pratt M, Sarmiento OL. Lessons learned after 10 years of IPAQ use in Brazil and Colombia. J Phys Act Health. 2010;7:S259–S264.
    1. Gomez Arnaiz A, Conde Martela A, Alberto Aguiar Bautista J, Manuel Santana Montesdeoca J, Jorrin Moreno A, Betancor Leon P. Diagnostic usefulness of Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous alcohol consumption in primary care settings. Med Clin (Barc) 2001;116:121–124.
    1. LS R. The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Appl Psyc Meas. 1977;1:385–401.
    1. Ruiz-Grosso P, Loret de Mola C, Vega-Dienstmaier JM, Arevalo JM, Chavez K, Vilela A, Lazo M, Huapaya J. Validation of the Spanish Center for Epidemiological Studies Depression and Zung Self-Rating Depression Scales: a comparative validation study. PloS One. 2012;7:e45413.
    1. Howe LD, Galobardes B, Matijasevich A, Gordon D, Johnston D, Onwujekwe O, Patel R, Webb EA, Lawlor DA, Hargreaves JR. Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper. Int J Epidemiol. 2012;41:871–886.
    1. McCracken JP, Smith KR, Diaz A, Mittleman MA, Schwartz J. Chimney stove intervention to reduce long-term wood smoke exposure lowers blood pressure among Guatemalan women. Environ Health Perspect. 2007;115:996–1001.
    1. Clark ML, Bachand AM, Heiderscheidt JM, Yoder SA, Luna B, Volckens J, Koehler KA, Conway S, Reynolds SJ, Peel JL. Impact of a cleaner-burning cookstove intervention on blood pressure in Nicaraguan women. Indoor Air. 2013;23:105–114.
    1. Parati G, Bilo G, Faini A, et al. Changes in 24 h ambulatory blood pressure and effects of angiotensin II receptor blockade during acute and prolonged high-altitude exposure: a randomized clinical trial. Eur Heart J. 2014;35:3113–3122.
    1. Hurtado A, Escudero E, Pando J, Sharma S, Johnson RJ. Cardiovascular and renal effects of chronic exposure to high altitude. Nephrol Dial Transplant. 2012;27:iv11–iv16.
    1. Zanobetti A, Canner MJ, Stone PH, Schwartz J, Sher D, Eagan-Bengston E, Gates KA, Hartley LH, Suh H, Gold DR. Ambient pollution and blood pressure in cardiac rehabilitation patients. Circulation. 2004;110:2184–2189.
    1. Urch B, Silverman F, Corey P, Brook JR, Lukic KZ, Rajagopalan S, Brook RD. Acute blood pressure responses in healthy adults during controlled air pollution exposures. Environl Health Perspect. 2005;113:1052–1055.
    1. Tornqvist H, Mills NL, Gonzalez M, Miller MR, Robinson SD, Megson IL, Macnee W, Donaldson K, Soderberg S, Newby DE, Sandstrom T, Blomberg A. Persistent endothelial dysfunction in humans after diesel exhaust inhalation. Am J Respir Crit Care Med. 2007;176:395–400.
    1. Sun Q, Yue P, Ying Z, Cardounel AJ, Brook RD, Devlin R, Hwang JS, Zweier JL, Chen LC, Rajagopalan S. Air pollution exposure potentiates hypertension through reactive oxygen species-mediated activation of Rho/ROCK. Arterioscler Thromb Vasc Biol. 2008;28:1760–1766.
    1. Mills NL, Tornqvist H, Robinson SD, Gonzalez M, Darnley K, MacNee W, Boon NA, Donaldson K, Blomberg A, Sandstrom T, Newby DE. Diesel exhaust inhalation causes vascular dysfunction and impaired endogenous fibrinolysis. Circulation. 2005;112:3930–3936.
    1. Auchincloss AH, Diez Roux AV, Dvonch JT, Brown PL, Barr RG, Daviglus ML, Goff DC, Kaufman JD, O'Neill MS. Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-ethnic Study of Atherosclerosis (MESA) Environ Health Perspect. 2008;116:486–491.
    1. Unosson J, Blomberg A, Sandstrom T, Muala A, Boman C, Nystrom R, Westerholm R, Mills NL, Newby DE, Langrish JP, Bosson JA. Exposure to wood smoke increases arterial stiffness and decreases heart rate variability in humans. Part Fibre Toxicol. 2013;10:20.
    1. Brook RD, Urch B, Dvonch JT, et al. Insights into the mechanisms and mediators of the effects of air pollution exposure on blood pressure and vascular function in healthy humans. Hypertension. 2009;54:659–667.
    1. Peters A, Frohlich M, Doring A, Immervoll T, Wichmann HE, Hutchinson WL, Pepys MB, Koenig W. Particulate air pollution is associated with an acute phase response in men; results from the MONICA-Augsburg Study. Eur Heart J. 2001;22:1198–1204.
    1. Pekkanen J, Brunner EJ, Anderson HR, Tiittanen P, Atkinson RW. Daily concentrations of air pollution and plasma fibrinogen in London. Occup Environ Med. 2000;57:818–822.
    1. Peters A, Doring A, Wichmann HE, Koenig W. Increased plasma viscosity during an air pollution episode: a link to mortality? Lancet. 1997;349:1582–1587.
    1. Frampton MW, Stewart JC, Oberdorster G, Morrow PE, Chalupa D, Pietropaoli AP, Frasier LM, Speers DM, Cox C, Huang LS, Utell MJ. Inhalation of ultrafine particles alters blood leukocyte expression of adhesion molecules in humans. Environ Health Perspect. 2006;114:51–58.
    1. Mills NL, Donaldson K, Hadoke PW, Boon NA, MacNee W, Cassee FR, Sandstrom T, Blomberg A, Newby DE. Adverse cardiovascular effects of air pollution. Nat Clin Pract Cardiovasc Med. 2009;6:36–44.
    1. Seaton A, MacNee W, Donaldson K, Godden D. Particulate air pollution and acute health effects. Lancet. 1995;345:176–178.
    1. Nemmar A, Hoet PH, Vanquickenborne B, Dinsdale D, Thomeer M, Hoylaerts MF, Vanbilloen H, Mortelmans L, Nemery B. Passage of inhaled particles into the blood circulation in humans. Circulation. 2002;105:411–414.
    1. Mills NL, Amin N, Robinson SD, Anand A, Davies J, Patel D, de la Fuente JM, Cassee FR, Boon NA, Macnee W, Millar AM, Donaldson K, Newby DE. Do inhaled carbon nanoparticles translocate directly into the circulation in humans? Am J Respir Crit Care Med. 2006;173:426–431.
    1. Baumgartner J, Zhang Y, Schauer JJ, Huang W, Wang Y, Ezzati M. Highway proximity and black carbon from cookstoves as a risk factor for higher blood pressure in rural China. Proc Natl Acad Sci USA. 2014;111:13229–13234.
    1. Pollard SL, Williams DL, Breysse PN, Baron PA, Grajeda LM, Gilman RH, Miranda JJ, Checkley W CRONICAS Cohort Study Group. A cross-sectional study of determinants of indoor environmental exposures in households with and without chronic exposure to biomass fuel smoke. Environ Health. 2014;13:21.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner