Association between long-term exposure to Sulfur dioxide pollution and hypertension incidence in northern China: a 12-ye
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RESEARCH ARTICLE
Association between long-term exposure to Sulfur dioxide pollution and hypertension incidence in northern China: a 12-year cohort study Mengfan Yan 1,2,3 & Chaokang Li 1,2,3 & Liwen Zhang 1,2,3 & Xi Chen 1,2,3 & Xueli Yang 1,2,3 & Anqi Shan 1,2,3 & Xuejun Li 1,2,3 & Hui Wu 1,2,3 & Zhao Ma 1,2,3 & Yu Zhang 1,2,3 & Pengyi Guo 1,2,3 & Guanghui Dong 4 & Yamin Liu 5 & Jie Chen 6 & Tong Wang 7 & Baoxin Zhao 8 & Nai-jun Tang 1,2,3 Received: 27 November 2019 / Accepted: 23 March 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Several studies have researched the short-term effect of sulfur dioxide (SO2) exposure on hypertension. However, no evidence has provided the relationship between long-term high pollution exposure of SO2 and morbidity of hypertension in cohort studies in China. This retrospective cohort study aimed to evaluate this association. We used Cox proportional hazards regression models to examine the hazard ratios (HR) for hypertension risks from 1998 to 2009 associated with accumulative exposure of air SO2 among adults in northern China. Annual average concentrations of sulfur dioxide (SO2) were obtained from 15 local environmental monitoring centers. Hypertension was identified according to self-reported diagnostic time and treatment for hypertension with anti-hypertensive medication. Among 37,386 participants, 2619 new cases of hypertension were identified during 426,334 person-years. In the fully adjusted model, HR and 95% confidence interval (CI) of hypertension incidence for each 10 μg/m3 increase in SO2 were 1.176 (1.163 and 1.189). Results from stratified analyses suggested that effects of SO2 on hypertension morbidity were more pronounced in participants < 60 years old, tea drinkers, and those with high education, high poultry consumption, and active (occasional and frequent) exercise. We found that long-term exposure to high levels of SO2 increased the risk of incidence of hypertension in China. Keywords Sulfur dioxide . Hypertension . Incidence . Cohort . Adults . China
Introduction As a well-established determinant of atherosclerosis development—the underlying pathology of most
cardiovascular disease (CVD) (Zhang et al. 2018)—hypertension is not only a serious risk factor of CVD such as stroke, myocardial infarction, and heart attack (Levy et al. 1996; Wong et al. 2012) but also a major contributor to an increase
Responsible editor: Philippe Garrigues Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11356-020-08572-z) contains supplementary material, which is available to authorized users. * Nai-jun Tang [email protected]
5
School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan 250062, China
1
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin 300070, China
6
Department of Occupational and Environmental Health, School of Public Health, China Medical Univ
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