Abstract 16521: Association of Air Pollution and Hypertension: An Updated Systematic Review and Meta-Analysis--2011-2018

IntroductionIt is well known that hypertension and elevated levels of air pollution are highly related, but the results of epidemiological studies remain controversial. We conducted an updated meta-analysis to assess the association between air pollution and hypertension.MethodsThe PUBMED databases were searched for all the studies published between January 2011 to March 2018, on investigating the association between ambient air particulate matter (PM2.5and PM10) and hypertension, defined by systolic blood pressure (BP)≥140 mm Hg/diastolic BP ≥90 mm Hg, or use of antihypertensive medications/ self-reported doctor-diagnosed high BP. A random-effects model was used to calculate overall risk estimates of air pollution. Heterogeneity and publication bias were examined to assess the generalizability of the findings in this study.ResultsOf 6134 identified studies, 75 were reviewed in-depth and 18 satisfied inclusion criteria with 178,301 hypertension cases, located in North America, Asia, and Europe. Seven studies evaluated the average exposure of PM2.5and PM10 for more than a 3-year period; and five studies provided estimates on people aged 50 years and over. Long-term exposure to PM2.5was significantly associated with an 11% increased risk of hypertension (risk:1.11, 95% confidence interval (CI)1.04,1.20) (Fig. A); each 10μg/m increment increase in long-term exposure to PM10 was associated with an 6% increase in risk of hypertension (risk:1.06, 95% CI1.04, 1.08). Heterogeneity among included studies of exposure to PM2.5was significant (P value for Q statistic=0.00, I=94.0%), but was not considerable among studies of exposure to PM10 (P value for Q statistic=0.19, I=30.1%). The results from Funnel plots and Egger’s tests suggested that there was no significant publication bias (Fig. B).ConclusionsThis study showed that exposure to ambient air particulate matter significantly increases the risk of hypertension. The associations between exposure to PM2.5 and hypertension were stronger in people with age of 50 years or older.