Associations between ambient air pollutants and blood pressure among children and adolescents: A systemic review and meta-analysis

Objective: Numerous epidemiological studies have investigated the effects of short-term and long-term exposure to ambient air pollution on hypertension and blood pressure among children and adolescents. However, the results were controversial. To provide researchers reliable evidence, this meta-analysis was performed. Methods: We searched all published studies in four databases examining the effects of particulate matter (PM10, PM2.5 and PM1.0), nitrogen oxide (NO2), sulfur dioxide (SO2), ozone (O-3) and carbon monoxide (CO) on hypertension and blood pressure in children and adolescents. Overall risk estimates associated with per 10 mu g/m(3) increase of air pollution were analyzed by a random-effect model for articles with significant heterogeneity, otherwise, a fixed-effect model was applied. Subgroup analysis was conducted for studies with significant heterogeneity. Results: Of 3918 identified literatures, 154 were evaluated in-depth with 15 satisfying inclusion criteria. Increased risk of hypertension was associated with long-term PM10 exposure (OR = 1.17,95% confidence interval [IC]:1.13, 1.21). For systolic blood pressure (SBP), significant results were found for short-term PM10 (beta = 026, 95% CI: -0.00, 0.53) exposure, long-term PM2.5 (beta = 1.80, 95% CI: 0.94, 2.65) and PM10 (beta = 0.50, 95% CI: 0.19, 0.81) exposure. The corresponding estimates of diastolic blood pressure (DBP) were 032 mmHg (95% CI: 0.19, 0.45) for short-term PM10 exposure, 1.06 mmHg (95% CI: 0.32, 1.80), 0.34 mmHg (95% CI: 0.11, 0.57) and 0.44 mmHg (95% CI: 0.25, 0.63) for long-term PM2.5, PM10 and NO2 exposure, respectively. Stratified analyses showed stronger effects of PM10 on blood pressure among studies with >= 50% boys' percentage (0.57 mmHg [95%a: 0.44, 0.70] for SBP, 0.44 mmHg, [95% CI: 0.34,0.54] for DBP, respectively) and artides using models to estimate exposure (0.90 mmHg [95% CI: 020 1.59] for SBP). Conclusion: Ambient air pollution was associated with higher hypertension prevalence and elevated blood pressure in children and adolescents. (C) 2021 Elsevier B.V. All rights reserved.

Automated summary

This meta-analysis study found that ambient air pollution is associated with an increased prevalence of hypertension and elevated blood pressure in children and adolescents.