Long-Term Exposure to Fine Particulate Matter and Hypertension Incidence in China: The China-PAR Cohort Study

• Type of Material: Article
• Authors: Keyong Huang, Emory University; Xueli Yang, Chinese Academy of Medical Sciences; Fengchao Liang, Chinese Academy of Medical Sciences; Fangchao Liu, Chinese Academy of Medical Sciences; Jianxin Li, Chinese Academy of Medical Sciences; Qingyang Xiao, Emory University; Jichun Chen, Chinese Academy of Medical Sciences; Xiaoqing Liu, Guangdong Provincial People’s Hospital and Cardiovascular Institute; Jie Cao, Chinese Academy of Medical Sciences; Chong Shen, Nanjing Medical University; Ling Yu, Emory University; Fanghong Lu, Shandong Academy of Medical Sciences; Xianping Wu, Sichuan Center for Disease Control and Prevention; Liancheng Zhao, Chinese Academy of Medical Sciences; Xigui Wu, Chinese Academy of Medical Sciences; Ying Li, Chinese Academy of Medical Sciences; Dongsheng Hu, Shenzhen University; Yang Liu, Emory University; Xiangfeng Lu, Chinese Academy of Sciences; Dongfeng Gu, Chinese Academy of Medical Sciences
• Language: English
• Date: 2019-06-01
• Publisher: Lippincott Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.12666
• Title of Journal or Parent Work: Hypertension
• Volume: 73
• Issue: 6
• Start Page: 1195
• End Page: 1201
• Grant/Funding Information: The work of Y. Liu was supported by the National Institutes of Health (grant no. R01ES027892) and assistance agreement no. 83586901 awarded by the US Environmental Protection Agency (EPA) (principle investigator: Y. Liu).; This work was supported by the National Key R&D Program of China (2017YFC0211703), the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (2017-I2M-1-004), National Natural Science Foundation of China (91643208), and the China Medical Board (15–220).
• Keywords: Prevalence; hypertension; cohort study; PM2.5; Science & Technology; Trends; Obesity; Ambient air pollution; Association; particulate matter; Global burden; Life Sciences & Biomedicine; air pollution; Risk; Cardiovascular System & Cardiology; Blood pressure; Peripheral Vascular Disease; risk
• Research Categories: Engineering, Environmental; Biology, Biostatistics; Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

The risk of incident hypertension associated with long-term exposure to fine particulate matter (PM2.5) was still unclear by studies conducted in North America and Europe, and this relationship has rarely been quantified at higher ambient concentrations typically found in developing countries. We aimed to investigate the association between PM2.5 and incident hypertension using the large-scale prospective cohorts in China. We included 59 456 participants without hypertension aged ≥18 years from the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. Data on ambient PM2.5 at participants' residential address were obtained during 2004 to 2015 using a satellite-based spatial-temporal model. Hazard ratios and 95% CIs were calculated for incident hypertension using stratified Cox proportional hazards models with adjustment of potential confounders. The findings indicated that average PM2.5 concentration from 2004 to 2015 at study participant's address was 77.7 μg/m3. During the followup of 364947 person-years, we identified 13 981 incident hypertension cases. Compared with the lowest quartile exposure of PM2.5, participants in the highest quartile had an increased risk of incident hypertension with a hazard ratio (95% CI) of 1.77 (1.56.2.00). Each 10 μg/m3 increment of PM2.5 concentration could increase 11% risk of hypertension (hazard ratio, 1.11; 95% CI, 1.05.1.17). This cohort study provided the first evidence from China that long-term exposure to PM2.5 was independently associated with incident hypertension at relatively high ambient concentrations. Stringent strategies on PM2.5 pollution control are warranted to improve the air quality and contribute to the reduction of disease burden of hypertension in China.