Associations of long-term exposure to ambient PM(1) with hypertension and blood pressure in rural Chinese population: The Henan rural cohort study

BACKGROUND: The epidemiological evidence on relationships between long-term exposure to particulate matter and hypertension and blood pressure has been inconclusive. Limited evidence was available for particulate matter with an aerodynamic diameter ≤ 1 μm (PM(1)) in rural areas of developing countries. OBJECTIVE: This study aimed to investigate the associations between long-term exposure to PM(1) and hypertension and blood pressure among rural Chinese population. METHODS: This study included 39,259 participants who had completed the baseline survey from Henan Rural Cohort. Participants' exposure to PM(1) was assessed by a satellite-based spatiotemporal model. The binary logistic regression model was used to examine the association between long-term PM(1) exposure and hypertension, and multivariable linear regression model was used to investigate the associations between long-term PM(1) exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Moreover, we examined potential effect modifications by demographic, lifestyle and diet factors. RESULTS: The mean concentration of PM(1) for all participants during the 3-year before baseline survey was 59.98 μg/m(3). Each 1 μg/m(3) increase in PM(1) concentration was significantly associated with an increase of 4.3% [Odds ratio(OR) = 1.043, 95% confidence interval(CI): 1.033, 1.053] in odds for hypertension, an increase of 0.401 mm Hg (95% CI, 0.335, 0.467), 0.328 mm Hg (95% CI, 0.288, 0.369), 0.353 mm Hg (95% CI, 0.307, 0.399) and 0.073 mm Hg (95% CI, 0.030, 0.116) in SBP, DBP, MAP and PP, respectively. Further stratified analyses showed that the effect of PM(1) on hypertension and blood pressure could be modified by sex, lifestyle and diet. CONCLUSIONS: This study suggests that long-term exposure to ambient PM(1) increases the risk of hypertension and is associated with elevations in blood pressure in rural Chinese adults, especially in male and those with unhealthy habits.