Outdoor air pollution enhanced the association between indoor air pollution exposure and hypertension in rural areas of eastern China

Recently, the high prevalence of hypertension (HTN) has caused serious disease burden. Previous studies mostly focused on the separate association between outdoor or indoor air pollution and HTN, and did not explore their possible interaction with HTN. To explore this issue, this study investigated the relationship between indoor and outdoor air pollution and HTN and their possible interactions among adult residents in 14 rural areas in eastern China. The generalized linear model (GLM) and interplot model were used to evaluate the separate effects and potential interaction of outdoor or indoor air pollutants on HTN. In separate analyses, we found a significant positive association between outdoor and indoor air pollution and HTN, and a significant negative association between range hood use and HTN. In the interaction analysis, outdoor air pollution could significantly enhance the positive effects of indoor air pollution on HTN. In addition, PM 2.5 and O 3 could significantly reduce the protective effect of range hoods use on HTN. Finally, we found that females were more susceptible to both indoor and outdoor air pollution.