Impact of a cleaner-burning cookstove intervention on blood pressure in Nicaraguan women

Few studies have evaluated the cardiovascular-related effects of indoor biomass burning or the role of characteristics such as age and obesity status, in this relationship. We examined the impact of a cleaner-burning cookstove intervention on blood pressure among Nicaraguan women using an open fire at baseline; we also evaluated heterogeneity of the impact by subgroups of the population. We evaluated changes in systolic and diastolic blood pressure from baseline to post-intervention (range: 273383days) among 74 female cooks. We measured indoor fine particulate matter (PM2.5; N=25), indoor carbon monoxide (CO; N=32), and personal CO (N=30) concentrations. Large mean reductions in pollutant concentrations were observed for all pollutants; for example, indoor PM2.5 was reduced 77% following the intervention. However, pollution distributions (baseline and post-intervention) were wide and overlapping. Although substantial reductions in blood pressure were not observed among the entire population, a 5.9mmHg reduction [95% confidence interval (CI): 11.3, 0.4] in systolic blood pressure was observed among women aged 40 or more years and a 4.6mmHg reduction (95% CI: 10.0, 0.8) was observed among obese women. Results from this study provide an indication that certain subgroups may be more likely to experience improvements in blood pressure following a cookstove intervention.