Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)

Foraster Pulido, Maria, 1984-; Basagaña Flores, Xavier; Aguilera Jiménez, Inmaculada, 1977-; Rivera, Marcela, 1982-; Agis, David; Bouso, Laura; Deltell, Alexandre; Marrugat, Jaume, 1954-; Ramos, Rafel; Sunyer Deu, Jordi; Vila, Joan; Elosua Llanos, Roberto; Künzli, Nino

Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)

Background: Long-term exposure to traffic-related air pollution may increase blood pressure (BP) and induce hypertension. However, evidence supporting these associations is limited, and they may be confounded by exposure to traffic noise and biased due to inappropriate control for use of BP-lowering...

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Autores:	Foraster Pulido, Maria, 1984-, Basagaña Flores, Xavier, Aguilera Jiménez, Inmaculada, 1977-, Rivera, Marcela, 1982-, Agis, David, Bouso, Laura, Deltell, Alexandre, Marrugat, Jaume, 1954-, Ramos, Rafel, Sunyer Deu, Jordi, Vila, Joan, Elosua Llanos, Roberto, Künzli, Nino
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2014
País:	España
Institución:	Universitat Pompeu Fabra
Repositorio:	Repositorio Digital de la UPF
OAI Identifier:	oai:repositori.upf.edu:10230/23393
Acceso en línea:	http://hdl.handle.net/10230/23393 http://dx.doi.org/10.1289/ehp.1306497
Access Level:	acceso abierto
Palabra clave:	Aire -- Contaminació -- Efectes fisiològics -- Epidemiologia Hipertensió

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spelling	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)Foraster Pulido, Maria, 1984-Basagaña Flores, XavierAguilera Jiménez, Inmaculada, 1977-Rivera, Marcela, 1982-Agis, DavidBouso, LauraDeltell, AlexandreMarrugat, Jaume, 1954-Ramos, RafelSunyer Deu, JordiVila, JoanElosua Llanos, RobertoKünzli, NinoAire -- Contaminació -- Efectes fisiològics -- EpidemiologiaHipertensióBackground: Long-term exposure to traffic-related air pollution may increase blood pressure (BP) and induce hypertension. However, evidence supporting these associations is limited, and they may be confounded by exposure to traffic noise and biased due to inappropriate control for use of BP-lowering medications. Objectives: We evaluated the associations of long-term traffic-related air pollution with BP and prevalent hypertension, adjusting for transportation noise and assessing different methodologies to control for BP-lowering medications. Methods: We measured systolic (SBP) and diastolic BP (DBP) at baseline (years 2003–2005) in 3,700 participants, 35–83 years of age, from a population-based cohort in Spain. We estimated home outdoor annual average concentrations of nitrogen dioxide (NO2) with a land-use regression model. We used multivariate linear and logistic regression. Results: A 10-μg/m3 increase in NO2 levels was associated with 1.34 mmHg (95% CI: 0.14, 2.55) higher SBP in nonmedicated individuals, after adjusting for transportation noise. Results were similar in the entire population after adjusting for medication, as commonly done, but weaker when other methods were used to account for medication use. For example, when 10 mmHg were added to the measured SBP levels of medicated participants, the association was β = 0.78 (95% CI: –0.43, 2.00). NO2 was not associated with hypertension. Associations of NO2 with SBP and DBP were stronger in participants with cardiovascular disease, and the association with SBP was stronger in those exposed to high traffic density and traffic noise levels ≥ 55 dB(A). Conclusions: We observed a positive association between long-term exposure to NO2 and SBP, after adjustment for transportation noise, which was sensitive to the methodology used to account for medication.This study was supported by funding from Marató 081632, Centre for Research in Environmental Epidemiology (CREAL) Pilot Project Funds 2009; Centro de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP) Pilot Project Funds 2008 (AA08_15); Instituto de Salud Carlos III (ISCIII): Fondo de Investigación Sanitaria (FIS) PI060258, Red de Investigación Cardiovascular–Programa Heracles RD 12/0042, Red de Investigación en Actividades Preventivas y Promoción de la Salud (RedIAPP) RD 06/0018, and a fellowship to M.F.; Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail (ANSES) CREAL 0966C0331 for the “Projet Tri-national Trafic, Air, Bruit et Santé” (TRI-TABS) study; and the Young Researchers Exchange Programme of the European Network on Noise and Health (ENNAH)National Institute of Environmental Health Sciences (NIEHS)201520152014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/23393http://dx.doi.org/10.1289/ehp.1306497reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésEnvironmental Health Perspectives. 2014;122(4):404-11Reproduced with permission from Environmental Health Perspectivesinfo:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/233932026-06-12T07:21:37Z
dc.title.none.fl_str_mv	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
title	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
spellingShingle	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study) Foraster Pulido, Maria, 1984- Aire -- Contaminació -- Efectes fisiològics -- Epidemiologia Hipertensió
title_short	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
title_full	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
title_fullStr	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
title_full_unstemmed	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
title_sort	Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)
dc.creator.none.fl_str_mv	Foraster Pulido, Maria, 1984- Basagaña Flores, Xavier Aguilera Jiménez, Inmaculada, 1977- Rivera, Marcela, 1982- Agis, David Bouso, Laura Deltell, Alexandre Marrugat, Jaume, 1954- Ramos, Rafel Sunyer Deu, Jordi Vila, Joan Elosua Llanos, Roberto Künzli, Nino
author	Foraster Pulido, Maria, 1984-
author_facet	Foraster Pulido, Maria, 1984- Basagaña Flores, Xavier Aguilera Jiménez, Inmaculada, 1977- Rivera, Marcela, 1982- Agis, David Bouso, Laura Deltell, Alexandre Marrugat, Jaume, 1954- Ramos, Rafel Sunyer Deu, Jordi Vila, Joan Elosua Llanos, Roberto Künzli, Nino
author_role	author
author2	Basagaña Flores, Xavier Aguilera Jiménez, Inmaculada, 1977- Rivera, Marcela, 1982- Agis, David Bouso, Laura Deltell, Alexandre Marrugat, Jaume, 1954- Ramos, Rafel Sunyer Deu, Jordi Vila, Joan Elosua Llanos, Roberto Künzli, Nino
author2_role	author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Aire -- Contaminació -- Efectes fisiològics -- Epidemiologia Hipertensió
topic	Aire -- Contaminació -- Efectes fisiològics -- Epidemiologia Hipertensió
description	Background: Long-term exposure to traffic-related air pollution may increase blood pressure (BP) and induce hypertension. However, evidence supporting these associations is limited, and they may be confounded by exposure to traffic noise and biased due to inappropriate control for use of BP-lowering medications. Objectives: We evaluated the associations of long-term traffic-related air pollution with BP and prevalent hypertension, adjusting for transportation noise and assessing different methodologies to control for BP-lowering medications. Methods: We measured systolic (SBP) and diastolic BP (DBP) at baseline (years 2003–2005) in 3,700 participants, 35–83 years of age, from a population-based cohort in Spain. We estimated home outdoor annual average concentrations of nitrogen dioxide (NO2) with a land-use regression model. We used multivariate linear and logistic regression. Results: A 10-μg/m3 increase in NO2 levels was associated with 1.34 mmHg (95% CI: 0.14, 2.55) higher SBP in nonmedicated individuals, after adjusting for transportation noise. Results were similar in the entire population after adjusting for medication, as commonly done, but weaker when other methods were used to account for medication use. For example, when 10 mmHg were added to the measured SBP levels of medicated participants, the association was β = 0.78 (95% CI: –0.43, 2.00). NO2 was not associated with hypertension. Associations of NO2 with SBP and DBP were stronger in participants with cardiovascular disease, and the association with SBP was stronger in those exposed to high traffic density and traffic noise levels ≥ 55 dB(A). Conclusions: We observed a positive association between long-term exposure to NO2 and SBP, after adjustment for transportation noise, which was sensitive to the methodology used to account for medication.
publishDate	2014
dc.date.none.fl_str_mv	2014 2015 2015
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	http://hdl.handle.net/10230/23393 http://dx.doi.org/10.1289/ehp.1306497
url	http://hdl.handle.net/10230/23393 http://dx.doi.org/10.1289/ehp.1306497
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.relation.none.fl_str_mv	Environmental Health Perspectives. 2014;122(4):404-11
dc.rights.none.fl_str_mv	Reproduced with permission from Environmental Health Perspectives info:eu-repo/semantics/openAccess
rights_invalid_str_mv	Reproduced with permission from Environmental Health Perspectives
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf application/pdf
dc.publisher.none.fl_str_mv	National Institute of Environmental Health Sciences (NIEHS)
publisher.none.fl_str_mv	National Institute of Environmental Health Sciences (NIEHS)
dc.source.none.fl_str_mv	reponame:Repositorio Digital de la UPF instname:Universitat Pompeu Fabra
instname_str	Universitat Pompeu Fabra
reponame_str	Repositorio Digital de la UPF
collection	Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Association of long-term exposure to traffic-related air pollution with blood pressure and hypertension in an adult population-based cohort in Spain (the REGICOR study)

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