Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension
Background: Despite the widespread availability of antihypertensive medications, residual cardiovascular risk of hypertension remained high. Limited studies have investigated the link between air pollution, particularly joint exposure to multiple air pollutants, with residual cardiovascular risk of...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651325001186 |
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| author | Yalan Li Wei Hong Jingjing Wu Jie Wang Shiqi Liu Hong Yuan Jingjing Cai Rujia Miao Jiangang Wang Yao Lu |
| author_facet | Yalan Li Wei Hong Jingjing Wu Jie Wang Shiqi Liu Hong Yuan Jingjing Cai Rujia Miao Jiangang Wang Yao Lu |
| author_sort | Yalan Li |
| collection | DOAJ |
| description | Background: Despite the widespread availability of antihypertensive medications, residual cardiovascular risk of hypertension remained high. Limited studies have investigated the link between air pollution, particularly joint exposure to multiple air pollutants, with residual cardiovascular risk of hypertension. Methods: 1981 hypertensive patients (≥ 18 years) from an ongoing longitudinal cohort in China, were enrolled between 2013 and 2019. Using high-quality datasets from China, the ground-level air pollutants concentrations, including PM2.5, PM2.5–10, SO2, O3, CO and NO2, at each participant’s residence were calculated. The relationships between individual and multiple air pollutants with the residual cardiovascular risk were assessed by Cox proportional hazards models, air pollution score analyses and Bayesian Kernel Machine Regression model. Results: Over an average follow-up period of 2.24 years (SD, 1.25), 706 hypertensive patients developed cardiovascular disease. In the single-pollutant analysis, higher concentrations of PM2.5, PM2.5–10, SO2 and CO were linked to increased residual cardiovascular risk. The air pollution score analyses and Bayesian kernel machine regression suggested that combined exposure to multiple air pollutants had a positive association with the residual cardiovascular risk, and NO2 played a dominant role. With higher NO2 concentrations, the hazard ratio of individual pollutants to residual cardiovascular risk increased. Conclusions: Prolonged exposure to a mixture of various air pollutants is linked to elevated residual cardiovascular risk in individuals with hypertension. Apart from taking antihypertensive medication and adopting healthy lifestyle behaviors, hypertensive patients should lower air pollutant exposure to decrease residual cardiovascular risk. |
| format | Article |
| id | doaj-art-a8c2b8c74bad401d8ced74e53722ac5b |
| institution | Kabale University |
| issn | 0147-6513 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-a8c2b8c74bad401d8ced74e53722ac5b2025-01-31T05:09:59ZengElsevierEcotoxicology and Environmental Safety0147-65132025-02-01291117782Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertensionYalan Li0Wei Hong1Jingjing Wu2Jie Wang3Shiqi Liu4Hong Yuan5Jingjing Cai6Rujia Miao7Jiangang Wang8Yao Lu9Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, ChinaDepartment of Cardiology, The Third Xiangya Hospital, Central South University, Changsha 410013, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Corresponding authors.Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Corresponding authors.Health Management Center, The Third Xiangya Hospital, Central South University, Changsha 410013, China; Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China; Faculty of Life Sciences & Medicine, King's College London, 150 Stamford Street, London SE1 9NH, UK; Correspondence to: Clinical Research Center, the Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha 410013, China.Background: Despite the widespread availability of antihypertensive medications, residual cardiovascular risk of hypertension remained high. Limited studies have investigated the link between air pollution, particularly joint exposure to multiple air pollutants, with residual cardiovascular risk of hypertension. Methods: 1981 hypertensive patients (≥ 18 years) from an ongoing longitudinal cohort in China, were enrolled between 2013 and 2019. Using high-quality datasets from China, the ground-level air pollutants concentrations, including PM2.5, PM2.5–10, SO2, O3, CO and NO2, at each participant’s residence were calculated. The relationships between individual and multiple air pollutants with the residual cardiovascular risk were assessed by Cox proportional hazards models, air pollution score analyses and Bayesian Kernel Machine Regression model. Results: Over an average follow-up period of 2.24 years (SD, 1.25), 706 hypertensive patients developed cardiovascular disease. In the single-pollutant analysis, higher concentrations of PM2.5, PM2.5–10, SO2 and CO were linked to increased residual cardiovascular risk. The air pollution score analyses and Bayesian kernel machine regression suggested that combined exposure to multiple air pollutants had a positive association with the residual cardiovascular risk, and NO2 played a dominant role. With higher NO2 concentrations, the hazard ratio of individual pollutants to residual cardiovascular risk increased. Conclusions: Prolonged exposure to a mixture of various air pollutants is linked to elevated residual cardiovascular risk in individuals with hypertension. Apart from taking antihypertensive medication and adopting healthy lifestyle behaviors, hypertensive patients should lower air pollutant exposure to decrease residual cardiovascular risk.http://www.sciencedirect.com/science/article/pii/S0147651325001186Residual Cardiovascular RiskAir pollutionJoint ExposureHypertension |
| spellingShingle | Yalan Li Wei Hong Jingjing Wu Jie Wang Shiqi Liu Hong Yuan Jingjing Cai Rujia Miao Jiangang Wang Yao Lu Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension Ecotoxicology and Environmental Safety Residual Cardiovascular Risk Air pollution Joint Exposure Hypertension |
| title | Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| title_full | Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| title_fullStr | Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| title_full_unstemmed | Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| title_short | Joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| title_sort | joint exposure to multiple air pollutants and residual cardiovascular risk in hypertension |
| topic | Residual Cardiovascular Risk Air pollution Joint Exposure Hypertension |
| url | http://www.sciencedirect.com/science/article/pii/S0147651325001186 |
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