Association of Long-Term Exposure to Traffic-Related Air Pollution with Blood Pressure and Hypertension in an Adult Population-Based Cohort in Spain (the REGICOR Study)

被引:72
|
作者
Foraster, Maria [1 ,2 ,3 ]
Basagana, Xavier [1 ,2 ]
Aguilera, Inmaculada [1 ,2 ]
Rivera, Marcela [4 ]
Agis, David [1 ,2 ]
Bouso, Laura [1 ,2 ]
Deltell, Alexandre [5 ,6 ]
Marrugat, Jaume [2 ,7 ]
Ramos, Rafel [8 ,9 ]
Sunyer, Jordi [2 ,3 ]
Vila, Joan [2 ,7 ]
Elosua, Roberto [2 ,7 ]
Kuenzli, Nino [10 ,11 ]
机构
[1] Ctr Res Environm Epidemiol CREAL, Barcelona 08003, Spain
[2] CIBERESP, Barcelona, Spain
[3] Univ Pompeu Fabra, Dept Ciencies Expt & Salut UPF, Barcelona, Spain
[4] Univ Montreal, Hosp Res Ctr CRCHUM, Montreal, PQ, Canada
[5] GREFEMA, Girona, Spain
[6] Univ Girona UdG, Girona, Spain
[7] IMIM Hosp Mar Med Res Inst, Barcelona, Spain
[8] Jordi Gol Inst Primary Care Res IDIAP JordiGol, Girona Inst Biomed Res IDIBGI, Catalan Inst Hlth, Catalunya, Spain
[9] Univ Girona, Sch Med, Dept Med Sci, Girona, Spain
[10] Swiss Trop & Publ Hlth Inst, Basel, Switzerland
[11] Univ Basel, Basel, Switzerland
关键词
FINE PARTICULATE MATTER; RISK; ATHEROSCLEROSIS; NOISE; PREVENTION; PARTICLES;
D O I
10.1289/ehp.1306497
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
BACKGROUND: Long-term exposure to traffic-related air pollution may increase blood pressure (BP) and induce hypertension. However, evidence supporting these associations is limited, and they may be confounded by exposure to traffic noise and biased due to inappropriate control for use of BP-lowering medications. OBJECTIVES: We evaluated the associations of long-term traffic-related air pollution with BP and prevalent hypertension, adjusting for transportation noise and assessing different methodologies to control for BP-lowering medications. METHODS: We measured systolic (SBP) and diastolic BP (DBP) at baseline (years 2003-2005) in 3,700 participants, 35-83 years of age, from a population-based cohort in Spain. We estimated home outdoor annual average concentrations of nitrogen dioxide (NO2) with a land-use regression model. We used multivariate linear and logistic regression. RESULTS: A 10-mu g/m(3) increase in NO2 levels was associated with 1.34 mmHg (95% CI: 0.14, 2.55) higher SBP in nonmedicated individuals, after adjusting for transportation noise. Results were similar in the entire population after adjusting for medication, as commonly done, but weaker when other methods were used to account for medication use. For example, when 10 mmHg were added to the measured SBP levels of medicated participants, the association was beta = 0.78 (95% CI: -0.43, 2.00). NO2 was not associated with hypertension. Associations of NO2 with SBP and DBP were stronger in participants with cardiovascular disease, and the association with SBP was stronger in those exposed to high traffic density and traffic noise levels >= 55 dB(A). CONCLUSIONS: We observed a positive association between long-term exposure to NO2 and SBP, after adjustment for transportation noise, which was sensitive to the methodology used to account for medication.
引用
收藏
页码:404 / 411
页数:8
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