Evidence linking air pollution and blood pressure mediated by body weight in China

Abstract

Air pollution is continuing to be at a high level in China, which may lead to an increased risk of obesity and hypertension. In the study, we aimed to examine the association between air pollution and prevalence of hypertension and tested whether this air pollution and hypertension association was mediated by changes in body weight. We used a linkage dataset from China with nationwide city-level air quality data linked with individual-level health data from the China Health and Retirement Longitudinal Study among adults aged 45 or older. Air quality was assessed based on the daily air quality index (AQI), a standard sum index of multiple air pollutants. To be specific, air pollution was measured by number of polluted days according to AQI and monthly average AQI. We examined the association between air quality and hypertension and tested mediation effect of body weight using a four-step mediating regression model. Air pollution was a risk factor for obesity. Each exposure to one more polluted day for females predicted on 2.1% (OR 1.021; 95% CI 1.007–1.035) higher prevalence of hypertension without BMI adjusted. A significant mediation effect of body mass index on the association between AQI and hypertension was observed. However, the effect of air pollution on hypertension among males was not significant. These results provide further evidence of the potential risks of air pollution and suggest that reducing pollution could help control both obesity and blood pressure.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. An R, Ji M, Yan H, Guan C (2018) Impact of ambient air pollution on obesity: a systematic review. Int J Obes 42:1112–1126

    CAS  Article  Google Scholar 

  2. Brauner EV, Mortensen J, Moller P et al (2009) Effects of ambient air particulate exposure on blood-gas barrier permeability and lung function. Inhal Toxicol 21(1):38e47

    Article  Google Scholar 

  3. Brook RD, Rajagopalan S (2009) Particulate matter air pollution blood pressure. J Am Soc Hypertension 3(5):332–350

    Article  Google Scholar 

  4. Brook RD, Rajagopalan S, Pope CA et al (2010) Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121(21):2331–2378

    CAS  Article  Google Scholar 

  5. Clougherty JE (2010) A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect 118(2):167e176

    Article  Google Scholar 

  6. Devlin RB, Ghio AJ, Kehrl H, Sanders G, Cascio W (2003) Elderly humans exposed to concentrated air pollution particles have decreased heart rate variability. Eur Respir J Suppl 40:76–80

  7. Feng XL, Pang M, Beard J (2014) Health system strengthening and hypertension awareness, treatment and control: data from the China health and retirement longitudinal study. B World Health Organ 92(1):29–41

    Article  Google Scholar 

  8. Iacobucci D (2012) Mediation analysis and categorical variables: the final frontier. J Consum Psychol 22:582–594

    Article  Google Scholar 

  9. Ibaldmulli A, Timonen KL, Peters A et al (2004) Effects of particulate air pollution on blood pressure and heart rate in subjects with cardiovascular disease: a multicenter approach. Environmen Health Perspect 112(3):369–377

    Article  Google Scholar 

  10. MacKinnon DP (2008) Introduction to statistical mediation analysis. Lawrence Erlbaum Assoc Inc, NY 2008

  11. Marr LC, Ely MR (2010) Effect of air pollution on marathon running performance. Med Sci Sports Exer 42(3):585–591

    CAS  Article  Google Scholar 

  12. Prisby RD, Muller-Delp J, Delp MD, Nurkiewicz TR (2008) Age, gender, and hormonal status modulate the vascular toxicity of the diesel exhaust extract phenanthraquinone. J Toxicol Environ Health A 71(7):464e470

    Article  Google Scholar 

  13. Sood A, Cui X, Qualls C et al (2008) Association between asthma and serum adiponectin concentration in women. Thorax 63(10):877e882

    Article  Google Scholar 

  14. Urch B, Silverman F, Corey P et al (2005) Acute blood pressure responses in healthy adults during controlled air pollution exposures. Environmen Health Perspect 113(8):1052–1055

    Article  Google Scholar 

  15. Wang B, Zhu Y, Pang Y, Xie J, Hao Y, Yan H et al (2018) Indoor air pollution affects hypertension risk in rural women in northern China by interfering with the uptake of metal elements: a preliminary cross-sectional study. Environmen Pollut 240:267–272

    CAS  Article  Google Scholar 

  16. Wayne E, Cascio M, Gilmour I, Peden DB (2015) Ambient Air Pollution and Increases in Blood Pressure Role for Biological Constituents of Particulate Matter. Hypertension 66:469–471

    Article  Google Scholar 

  17. Wei YJ, Zhang JF, Li ZG, Gow A et al (2016) Chronic exposure to air pollution particles increases the risk of obesity and metabolic syndrome: findings from a natural experiment in Beijing. FASEB J 30(6):2115–2122

    CAS  Article  Google Scholar 

  18. WHO (2000) Obesity: preventing and managing the global epidemic. World Health Organization, Geneva

    Google Scholar 

  19. WHO (2018) Air pollution level, http://www.who.int/airpollution/en/. Accessed 28 Oct 2018

  20. WHO (2013) A global brief on hypertension. http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1. Accessed 28 Oct 2018

  21. Yang BY, Qian Z, Howard SW et al (2018) Global association between ambient air pollution and blood pressure: a systematic review and meta-analysis. Environmen Pollut 235:576–588

    CAS  Article  Google Scholar 

  22. Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol 43(1):61

    Article  Google Scholar 

Download references

Funding

The study was carried out with the financial support from China Postdoctoral Science Foundation (No. 2018m630284); The Fundamental Research Funds of Shandong University (No.2019GN120); Clinical Special Funds of Shanghai health commission.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Qing Wang.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wang, Q., Gracely, E.J. & Liu, L. Evidence linking air pollution and blood pressure mediated by body weight in China. Air Qual Atmos Health 13, 585–592 (2020). https://doi.org/10.1007/s11869-020-00821-x

Download citation

Keywords

  • Air pollution
  • Blood pressure
  • Body weight
  • The air quality index
  • Suspended particulates