Prevalence of hypertension increases exponentially with proximity to roadways in an adult cardiac catheterination cohort

摘要

Background: Previous epidemiologic studies have suggested that residential proximity to traffic increases cardiovascular disease risk factors and endophenotypes in major urban areas. Objectives: We examined the associations between mobile source air pollution and hypertension in an environment less urban than the major metropolitan areas previously studied. Methods: We utilized a cohort of 2,123 patients with outpatient cardiac catheterization at the Duke Cardiac Catheterization clinic (CATHGEN), who resided within Durham, Wake, or Orange Counties, North Carolina. We computed the inverse exponential distance to the nearest primary or secondary roadway. Associations were examined using generalized additive models adjusting for sex, race, smoking and socioeconomic status (median home value). We further adjusted for the annual average of PM2.5 in a subset of these patients (N = 1,806). Odds ratios (OR) and confidence intervals (CI) were calculated per interquartile range decrease in distance to roadways. Results: Hypertension prevalence showed an inverse exponential association with distance to primary or secondary roadway in an unadjusted model (OR = 1.21, 95% CI: 1.06 -1.37). A full model adjusted for race, sex, smoking, and median home value only slightly attenuated the association (OR = 1.17, 95% CI: 1.03 -1.33). Additional adjustment of the full model for background PM2.5 (annual average) using the EPA's Fused Air Quality Surfaces Using Downscaling data had no meaningful effect on the association (OR = 1.21, 95% CI: 1.05 -1.40). Conclusions: Even in less urban environments, hypertension was associated with proximity to major roadways. This association was independent of the annual average PM2.5 at the census tract level for each residence. This proposed abstract does not necessarily reflect EPA policy.