Short- and Long-Term Effects of Inhaled Ultrafine Particles on Blood Pressure: A Systematic Review and Meta-Analysis

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Nov 27

PMID 39597946

Authors

Joanna Izabela Lachowicz

Pawel Gac

Affiliations

Soon will be listed here.

Abstract

Air pollution contributes to up to 60% of premature mortality worldwide by worsening cardiovascular conditions. Ultrafine particles (UFPs) may negatively affect cardiovascular outcomes, and epidemiological studies have linked them to short- and long-term blood pressure (BP) imbalance. We conducted a systematic review and meta-analysis of the short- and long-term effects of UFP exposure on systolic (SBP) and diastolic (DBP) blood pressure. Eligibility criteria were established using the Population, Exposure, Comparator, Outcome, and Study Design (PECOS) model, and literature searches were conducted in Web of Science, PubMed, Embase, and Scopus for studies published between 1 January 2013 and 9 October 2024. Risk of Bias (RoB) was assessed following World Health Organization (WHO) instructions. Separate meta-analyses were performed for the short- and long-term effects of UFP exposure on SBP and DBP. Additionally, we analyzed SBP and DBP imbalances across different timespans following short-term exposure. The results showed an increase in BP during short-term UFP exposure, which returned to baseline values after a few hours. Changes in SBP were greater than in DBP following both short- and long-term exposure. Prolonged exposure to UFPs is associated with increased SBP and concurrently low DBP values. Chronic exposure to UFPs may lead to a persistent increase in SBP, even without a concurrent increase in DBP. The findings presented here highlight that UFPs may contribute to worsening cardiovascular outcomes in vulnerable populations living in air-polluted areas.

References

Corlin L, Woodin M, Hart J, Simon M, Gute D, Stowell J . Longitudinal associations of long-term exposure to ultrafine particles with blood pressure and systemic inflammation in Puerto Rican adults. Environ Health. 2018; 17(1):33. PMC: 5887259. DOI: 10.1186/s12940-018-0379-9. View

Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W . Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019; 394(10204):1145-1158. PMC: 6891889. DOI: 10.1016/S0140-6736(19)30427-1. View

Nwabuo C, Appiah D, Moreira H, Vasconcellos H, Yano Y, Reis J . Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study. Eur J Prev Cardiol. 2021; 28(13):1445-1451. PMC: 8653578. DOI: 10.1177/2047487320915342. View

Lee J, Hong J, Lee S, An S, Shin A, Park S . Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study. PLoS One. 2022; 17(6):e0270510. PMC: 9246156. DOI: 10.1371/journal.pone.0270510. View

Kannel W, DAWBER T, McGee D . Perspectives on systolic hypertension. The Framingham study. Circulation. 1980; 61(6):1179-82. DOI: 10.1161/01.cir.61.6.1179. View

McEvoy J, McCarthy C, Bruno R, Brouwers S, Canavan M, Ceconi C . 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024; 45(38):3912-4018. DOI: 10.1093/eurheartj/ehae178. View

Tsao C, Aday A, Almarzooq Z, Alonso A, Beaton A, Bittencourt M . Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022; 145(8):e153-e639. DOI: 10.1161/CIR.0000000000001052. View

Munzel T, Sorensen M, Gori T, Schmidt F, Rao X, Brook F . Environmental stressors and cardio-metabolic disease: part II-mechanistic insights. Eur Heart J. 2016; 38(8):557-564. PMC: 5381593. DOI: 10.1093/eurheartj/ehw294. View

Neyeloff J, Fuchs S, Moreira L . Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes. 2012; 5:52. PMC: 3296675. DOI: 10.1186/1756-0500-5-52. View

10.

Rethlefsen M, Kirtley S, Waffenschmidt S, Ayala A, Moher D, Page M . PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst Rev. 2021; 10(1):39. PMC: 7839230. DOI: 10.1186/s13643-020-01542-z. View

11.

Vasan R, Larson M, Leip E, Evans J, ODonnell C, Kannel W . Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2002; 345(18):1291-7. DOI: 10.1056/NEJMoa003417. View

12.

Morishita M, Bard R, Wang L, Das R, Dvonch J, Spino C . The characteristics of coarse particulate matter air pollution associated with alterations in blood pressure and heart rate during controlled exposures. J Expo Sci Environ Epidemiol. 2014; 25(2):153-9. PMC: 4462122. DOI: 10.1038/jes.2014.62. View

13.

Vidal-Petiot E, Ford I, Greenlaw N, Ferrari R, Fox K, Tardif J . Cardiovascular event rates and mortality according to achieved systolic and diastolic blood pressure in patients with stable coronary artery disease: an international cohort study. Lancet. 2016; 388(10056):2142-2152. DOI: 10.1016/S0140-6736(16)31326-5. View

14.

Meier R, Cascio W, Ghio A, Wild P, Danuser B, Riediker M . Associations of short-term particle and noise exposures with markers of cardiovascular and respiratory health among highway maintenance workers. Environ Health Perspect. 2014; 122(7):726-32. PMC: 4080522. DOI: 10.1289/ehp.1307100. View

15.

Yetkin E, Ozturk S, Cuglan B, Turhan H . Golden ratio in congestive heart failure: A promising proportion for prognosis and decompensation. Cardiol J. 2021; 27(6):904-905. PMC: 8079101. DOI: 10.5603/CJ.2020.0177. View

16.

Liu J, Hsiao T, Lee K, Chuang H, Cheng T, Chuang K . Association of ultrafine particles with cardiopulmonary health among adult subjects in the urban areas of northern Taiwan. Sci Total Environ. 2018; 627:211-215. DOI: 10.1016/j.scitotenv.2018.01.218. View

17.

Chung M, Wang D, Rizzo A, Gachette D, Delnord M, Parambi R . Association of PNC, BC, and PM2.5 measured at a central monitoring site with blood pressure in a predominantly near highway population. Int J Environ Res Public Health. 2015; 12(3):2765-80. PMC: 4377931. DOI: 10.3390/ijerph120302765. View

18.

Roswall N, Poulsen A, Hvidtfeldt U, Hendriksen P, Boll K, Halkjaer J . Exposure to ambient air pollution and lipid levels and blood pressure in an adult, Danish cohort. Environ Res. 2022; 220:115179. DOI: 10.1016/j.envres.2022.115179. View

19.

Pieters N, Koppen G, Poppel M, De Prins S, Cox B, Dons E . Blood Pressure and Same-Day Exposure to Air Pollution at School: Associations with Nano-Sized to Coarse PM in Children. Environ Health Perspect. 2015; 123(7):737-42. PMC: 4492263. DOI: 10.1289/ehp.1408121. View

20.

Wang Y, Song L, Xing A, Gao M, Zhao H, Li C . Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events. Sci Rep. 2017; 7:41969. PMC: 5294637. DOI: 10.1038/srep41969. View