Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 2001 Apr;91(4):571–577. doi: 10.2105/ajph.91.4.571

Effects of air pollution on blood pressure: a population-based approach.

A Ibald-Mulli 1, J Stieber 1, H E Wichmann 1, W Koenig 1, A Peters 1
PMCID: PMC1446632  PMID: 11291368

Abstract

OBJECTIVES: This analysis assessed the association between blood pressure, meteorology, and air pollution in a random population sample. METHODS: Blood pressure measurements of 2607 men and women aged 25 to 64 years who participated in the Augsburg Monitoring of Trends and Determinants in Cardiovascular Disease survey were analyzed in association with 24-hour mean concentrations of air pollutants. RESULTS: During the air pollution episode in Europe in January 1985, an association between blood pressure and air pollution was observed, which disappeared after adjustment for meteorology. Continuous concentrations of total suspended particulates and sulfur dioxide were associated with an increase in systolic blood pressure of 1.79 mm Hg (95% confidence interval [CI] = 0.63, 2.95) per 90 micrograms/m3 total suspended particulates and 0.74 mm Hg (95% CI = 0.08, 1.40) per 80 micrograms/m3 sulfur dioxide. In subgroups with high plasma viscosity levels and increased heart rates, systolic blood pressure increased by 6.93 mm Hg (95% CI = 4.31, 9.75) and 7.76 mm Hg (95% CI = 5.70, 9.82) in association with total suspended particulates. CONCLUSIONS: The observed increase in systolic blood pressure associated with ambient air pollution could be related to a change in cardiovascular autonomic control.

Full Text

The Full Text of this article is available as a PDF (128.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borja-Aburto V. H., Castillejos M., Gold D. R., Bierzwinski S., Loomis D. Mortality and ambient fine particles in southwest Mexico City, 1993-1995. Environ Health Perspect. 1998 Dec;106(12):849–855. doi: 10.1289/ehp.106-1533229. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bouthillier L., Vincent R., Goegan P., Adamson I. Y., Bjarnason S., Stewart M., Guénette J., Potvin M., Kumarathasan P. Acute effects of inhaled urban particles and ozone: lung morphology, macrophage activity, and plasma endothelin-1. Am J Pathol. 1998 Dec;153(6):1873–1884. doi: 10.1016/S0002-9440(10)65701-X. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burnett R. T., Cakmak S., Brook J. R., Krewski D. The role of particulate size and chemistry in the association between summertime ambient air pollution and hospitalization for cardiorespiratory diseases. Environ Health Perspect. 1997 Jun;105(6):614–620. doi: 10.1289/ehp.97105614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Burnett R. T., Smith-Doiron M., Stieb D., Cakmak S., Brook J. R. Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. Arch Environ Health. 1999 Mar-Apr;54(2):130–139. doi: 10.1080/00039899909602248. [DOI] [PubMed] [Google Scholar]
  5. Chalmers J., MacMahon S., Mancia G., Whitworth J., Beilin L., Hansson L., Neal B., Rodgers A., Ni Mhurchu C., Clark T. 1999 World Health Organization-International Society of Hypertension Guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization. Clin Exp Hypertens. 1999 Jul-Aug;21(5-6):1009–1060. doi: 10.3109/10641969909061028. [DOI] [PubMed] [Google Scholar]
  6. Dab W., Medina S., Quénel P., Le Moullec Y., Le Tertre A., Thelot B., Monteil C., Lameloise P., Pirard P., Momas I. Short term respiratory health effects of ambient air pollution: results of the APHEA project in Paris. J Epidemiol Community Health. 1996 Apr;50 (Suppl 1):s42–s46. doi: 10.1136/jech.50.suppl_1.s42. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Delfino R. J., Becklake M. R., Hanley J. A. The relationship of urgent hospital admissions for respiratory illnesses to photochemical air pollution levels in Montreal. Environ Res. 1994 Oct;67(1):1–19. doi: 10.1006/enrs.1994.1061. [DOI] [PubMed] [Google Scholar]
  8. Gold D. R., Litonjua A., Schwartz J., Lovett E., Larson A., Nearing B., Allen G., Verrier M., Cherry R., Verrier R. Ambient pollution and heart rate variability. Circulation. 2000 Mar 21;101(11):1267–1273. doi: 10.1161/01.cir.101.11.1267. [DOI] [PubMed] [Google Scholar]
  9. Grassi G. Role of the sympathetic nervous system in human hypertension. J Hypertens. 1998 Dec;16(12 Pt 2):1979–1987. doi: 10.1097/00004872-199816121-00019. [DOI] [PubMed] [Google Scholar]
  10. Haynes W. G., Webb D. J. Endothelin as a regulator of cardiovascular function in health and disease. J Hypertens. 1998 Aug;16(8):1081–1098. doi: 10.1097/00004872-199816080-00001. [DOI] [PubMed] [Google Scholar]
  11. Hense H. W., Koivisto A. M., Kuulasmaa K., Zaborskis A., Kupsc W., Tuomilehto J. Assessment of blood pressure measurement quality in the baseline surveys of the WHO MONICA project. J Hum Hypertens. 1995 Dec;9(12):935–946. [PubMed] [Google Scholar]
  12. Keil U., Stieber J., Döring A., Chambless L., Härtel U., Filipiak B., Hense H. W., Tietze M., Gostomzyk J. G. The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85. Acta Med Scand Suppl. 1988;728:119–128. doi: 10.1111/j.0954-6820.1988.tb05563.x. [DOI] [PubMed] [Google Scholar]
  13. Kirkendall W. M., Feinleib M., Freis E. D., Mark A. L. Recommendations for human blood pressure determination by sphygmomanometers. Subcommittee of the AHA Postgraduate Education Committee. Hypertension. 1981 Jul-Aug;3(4):510A–519A. [PubMed] [Google Scholar]
  14. Koenig W., Sund M., Ernst E., Keil U., Rosenthal J., Hombach V. Association between plasma viscosity and blood pressure. Results from the MONICA-project Augsburg. Am J Hypertens. 1991 Jun;4(6):529–536. doi: 10.1093/ajh/4.6.529. [DOI] [PubMed] [Google Scholar]
  15. Koenig W., Sund M., Lowe G. D., Lee A. J., Resch K. L., Tunstall-Pedoe H., Keil U., Ernst E. Geographical variations in plasma viscosity and relation to coronary event rates. Lancet. 1994 Sep 10;344(8924):711–714. doi: 10.1016/s0140-6736(94)92207-1. [DOI] [PubMed] [Google Scholar]
  16. Liao D., Creason J., Shy C., Williams R., Watts R., Zweidinger R. Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. Environ Health Perspect. 1999 Jul;107(7):521–525. doi: 10.1289/ehp.99107521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nakamura K., Sasaki S., Moriguchi J., Morimoto S., Miki S., Kawa T., Itoh H., Nakata T., Takeda K., Nakagawa M. Central effects of endothelin and its antagonists on sympathetic and cardiovascular regulation in SHR-SP. J Cardiovasc Pharmacol. 1999 Jun;33(6):876–882. doi: 10.1097/00005344-199906000-00007. [DOI] [PubMed] [Google Scholar]
  18. Peters A., Döring A., Wichmann H. E., Koenig W. Increased plasma viscosity during an air pollution episode: a link to mortality? Lancet. 1997 May 31;349(9065):1582–1587. doi: 10.1016/S0140-6736(97)01211-7. [DOI] [PubMed] [Google Scholar]
  19. Peters A., Perz S., Döring A., Stieber J., Koenig W., Wichmann H. E. Increases in heart rate during an air pollution episode. Am J Epidemiol. 1999 Nov 15;150(10):1094–1098. doi: 10.1093/oxfordjournals.aje.a009934. [DOI] [PubMed] [Google Scholar]
  20. Pope CA3rd, Dockery D. W., Kanner R. E., Villegas G. M., Schwartz J. Oxygen saturation, pulse rate, and particulate air pollution: A daily time-series panel study. Am J Respir Crit Care Med. 1999 Feb;159(2):365–372. doi: 10.1164/ajrccm.159.2.9702103. [DOI] [PubMed] [Google Scholar]
  21. Pope C. A., 3rd, Bates D. V., Raizenne M. E. Health effects of particulate air pollution: time for reassessment? Environ Health Perspect. 1995 May;103(5):472–480. doi: 10.1289/ehp.95103472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pope C. A., 3rd, Hill R. W., Villegas G. M. Particulate air pollution and daily mortality on Utah's Wasatch Front. Environ Health Perspect. 1999 Jul;107(7):567–573. doi: 10.1289/ehp.99107567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Pope C. A., 3rd, Verrier R. L., Lovett E. G., Larson A. C., Raizenne M. E., Kanner R. E., Schwartz J., Villegas G. M., Gold D. R., Dockery D. W. Heart rate variability associated with particulate air pollution. Am Heart J. 1999 Nov;138(5 Pt 1):890–899. doi: 10.1016/s0002-8703(99)70014-1. [DOI] [PubMed] [Google Scholar]
  24. Prescott G. J., Cohen G. R., Elton R. A., Fowkes F. G., Agius R. M. Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occup Environ Med. 1998 Oct;55(10):697–704. doi: 10.1136/oem.55.10.697. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Schwartz J. Air pollution and daily mortality: a review and meta analysis. Environ Res. 1994 Jan;64(1):36–52. doi: 10.1006/enrs.1994.1005. [DOI] [PubMed] [Google Scholar]
  26. Schwartz J. Air pollution and hospital admissions for heart disease in eight U.S. counties. Epidemiology. 1999 Jan;10(1):17–22. [PubMed] [Google Scholar]
  27. Seaton A., MacNee W., Donaldson K., Godden D. Particulate air pollution and acute health effects. Lancet. 1995 Jan 21;345(8943):176–178. doi: 10.1016/s0140-6736(95)90173-6. [DOI] [PubMed] [Google Scholar]
  28. Sheppard L., Levy D., Norris G., Larson T. V., Koenig J. Q. Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987-1994. Epidemiology. 1999 Jan;10(1):23–30. [PubMed] [Google Scholar]
  29. Spix C., Wichmann H. E. Daily mortality and air pollutants: findings from Köln, Germany. J Epidemiol Community Health. 1996 Apr;50 (Suppl 1):s52–s58. doi: 10.1136/jech.50.suppl_1.s52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Thurston G. D. A critical review of PM10-mortality time-series studies. J Expo Anal Environ Epidemiol. 1996 Jan-Mar;6(1):3–21. [PubMed] [Google Scholar]
  31. Welin L., Eriksson H., Larsson B., Svärdsudd K., Wilhelmsen L., Tibblin G. Risk factors for coronary heart disease during 25 years of follow-up. The study of men born in 1913. Cardiology. 1993;82(2-3):223–228. doi: 10.1159/000175869. [DOI] [PubMed] [Google Scholar]
  32. Wichmann H. E., Mueller W., Allhoff P., Beckmann M., Bocter N., Csicsaky M. J., Jung M., Molik B., Schoeneberg G. Health effects during a smog episode in West Germany in 1985. Environ Health Perspect. 1989 Feb;79:89–99. doi: 10.1289/ehp.897989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Zmirou D., Schwartz J., Saez M., Zanobetti A., Wojtyniak B., Touloumi G., Spix C., Ponce de León A., Le Moullec Y., Bacharova L. Time-series analysis of air pollution and cause-specific mortality. Epidemiology. 1998 Sep;9(5):495–503. [PubMed] [Google Scholar]
  34. de Leeuw F. A., Leyssius H. J. Long-range transport modeling of air pollution episodes. Environ Health Perspect. 1989 Feb;79:53–59. doi: 10.1289/ehp.897953. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES