Long-term exposure to fine particulate matter modifies the association between physical activity and hypertension incidence |
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| Institution: | 1. Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;2. Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China;3. School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China;4. Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China;5. Division of Epidemiology, Guangdong Provincial People''s Hospital and Cardiovascular Institute, Guangzhou 510080, China;6. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China;7. Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China;8. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China;9. Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China;10. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China;11. Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China;12. Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;13. School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China |
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| Abstract: | BackgroundThe trade-off between the benefits of regular physical activity (PA) and the potentially detrimental effects of augmented exposure to air pollution in highly polluted regions remains unclear. This study aimed to examine whether ambient fine particulate matter (PM2.5) exposure modified the impacts of PA volume and intensity on hypertension risk.MethodsWe included 54,797 participants without hypertension at baseline in a nationwide cohort of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. PA volume and intensity were assessed by questionnaire, and high-resolution (1 km ×1 km) PM2.5 estimates were generated using a satellite-based model.ResultsDuring 413,516 person-years of follow-up, 12,100 incident hypertension cases were identified. PM2.5 significantly modified the relationship between PA and hypertension incidence (pinteraction < 0.001). Increased PA volume was negatively associated with incident hypertension in the low PM2.5 stratum (<59.8 μg/m3, ptrend < 0.001), with a hazard ratio of 0.81 (95% confidence interval (95%CI): 0.74–0.88) when comparing the fourth with the first quartile of PA volume. However, the health benefits were not observed in the high PM2.5 stratum (≥59.8 μg/m3, ptrend = 0.370). Moreover, compared with light PA intensity, vigorous intensity was related to a 20% (95%CI: 9%–29%) decreased risk of hypertension for participants exposed to low PM2.5, but a 17% (95%CI: 4%–33%) increased risk for those with high PM2.5 levels.ConclusionPA was associated with a reduced risk of hypertension only among participants with low PM2.5 exposure. Our findings recommended regular PA to prevent hypertension in less polluted regions and reinforced the importance of air quality improvement. |
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