Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Hypertension | Research

Sex differences and dietary patterns in the association of air pollutants and hypertension

Authors: Chen Zhang, Yuanyuan Wang, Wei Xie, Jingxian Zhang, Ting Tian, Qianrang Zhu, Xinyu Fang, Jing Sui, Da Pan, Hui Xia, Shaokang Wang, Guiju Sun, Yue Dai

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Hypertension is one of the major public health problems in China. Limited evidence exists regarding sex differences in the association between hypertension and air pollutants, as well as the impact of dietary factors on the relationship between air pollutants and hypertension. The aim of this study was to investigate the sex-specific effects of dietary patterns on the association between fine particulate matter (PM2.5), ozone(O3) and hypertension in adults residing in Jiangsu Province of China.

Methods

A total of 3189 adults from the 2015 China Adult Chronic Disease and Nutrition Surveillance in Jiangsu Province were included in this study. PM2.5 and O3 concentrations were estimated using satellite space-time models and assigned to each participant. Dietary patterns were determined by reduced rank regression (RRR), and multivariate logistic regression was used to assess the associations of the obtained dietary patterns with air pollutants and hypertension risk.

Results

After adjusting for confounding variables, we found that males were more sensitive to long-term exposure to PM2.5 (Odds ratio (OR) = 1.42 95%CI:1.08,1.87), and females were more sensitive to long-term exposure to O3 (OR = 1.61 95%CI:1.15,2.23). Traditional southern pattern identified through RRR exhibited a protective effect against hypertension in males (OR = 0.73 95%CI: 0.56,1.00). The results of the interaction between dietary pattern score and PM2.5 revealed that adherence to traditional southern pattern was significantly associated with a decreased risk of hypertension in males (P < 0.05), while no significant association was observed among females.

Conclusions

Our findings suggested that sex differences existed in the association between dietary patterns, air pollutants and hypertension. Furthermore, we found that adherence to traditional southern pattern may mitigate the risk of long-term PM2.5 exposure-induced hypertension in males.
Literature
1.
Zhou B, Carrillo-Larco RM, Danaei G, Riley LM, Paciorek CJ, Stevens GA, Gregg EW, Bennett JE, Solomon B, Singleton RK. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957–80.CrossRef
2.
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, Chen J, He J. Global disparities of hypertension prevalence and control: a systematic analysis of Population-Based studies from 90 countries. Circulation. 2016;134(6):441–50.PubMedPubMedCentralCrossRef
3.
Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y. 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):1145–58.PubMedPubMedCentralCrossRef
4.
Kontis V, Mathers CD, Rehm J, Stevens GA, Shield KD, Bonita R, Riley LM, Poznyak V, Beaglehole R, Ezzati M. Contribution of six risk factors to achieving the 25×25 non-communicable disease mortality reduction target: a modelling study. Lancet. 2014;384(9941):427–37.PubMedCrossRef
5.
6.
Ciencewicki J, Jaspers I. Air pollution and respiratory viral infection. Inhal Toxicol. 2007;19(14):1135–46.PubMedCrossRef
7.
Global regional. National disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet. 2018;392(10159):1859–922.CrossRef
8.
de Bont J, Jaganathan S, Dahlquist M, Persson Å, Stafoggia M, Ljungman P. Ambient air pollution and cardiovascular diseases: an umbrella review of systematic reviews and meta-analyses. J Intern Med. 2022;291(6):779–800.PubMedPubMedCentralCrossRef
9.
Wang M, Zhou T, Song Q, Ma H, Hu Y, Heianza Y, Qi L. Ambient air pollution, healthy diet and vegetable intakes, and mortality: a prospective UK Biobank study. Int J Epidemiol. 2022;51(4):1243–53.PubMedPubMedCentralCrossRef
10.
Lim CC, Hayes RB, Ahn J, Shao Y, Silverman DT, Jones RR, Thurston GD. Mediterranean Diet and the Association between Air Pollution and Cardiovascular Disease Mortality Risk. Circulation. 2019;139(15):1766–75.PubMedPubMedCentralCrossRef
11.
Hoffmann K, Schulze MB, Schienkiewitz A, Nöthlings U, Boeing H. Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol. 2004;159(10):935–44.PubMedCrossRef
12.
Lazarova SV, Jessri M. Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique. Am J Clin Nutr. 2022;116(2):362–77.PubMedPubMedCentralCrossRef
13.
Yang Y, Piao W, Cai S, Huang K, Yuan C, Cheng X, Zhang L, Li Y, Zhao L, Yu D. Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study. Eur J Nutr. 2023;62(7):2805–25.PubMedCrossRef
14.
Xiao QY, Geng GN, Cheng J, Liang FC, Li R, Meng X, Xue T, Huang XM, Kan HD, Zhang Q et al. Evaluation of gap-filling approaches in satellite-based daily PM2.5 prediction models. Atmos Environ 2021, 244.
15.
Xiao Q, Zheng Y, Geng G, Chen C, Huang X, Che H, Zhang X, He K, Zhang Q. Separating emission and meteorological contributions to long-term PM2.5 trends over eastern China during 2000–2018. Atmos Chem Phys. 2021;21(12):9475–96.CrossRef
16.
Spatiotemporal continuous estimates of daily 1 km PM2.5 from 2000 to present under the Tracking Air Pollution in China (TAP) framework. Atmos Chem Phys 2022, 22(19):13229–13242.
17.
Geng G, Xiao Q, Liu S, Liu X, Cheng J, Zheng Y, Xue T, Tong D, Zheng B, Peng Y, et al. Tracking Air Pollution in China: Near Real-Time PM(2.5) retrievals from Multisource Data Fusion. Environ Sci Technol. 2021;55(17):12106–15.PubMedCrossRef
18.
Xue T, Zheng Y, Geng G, Xiao Q, Meng X, Wang M, Li X, Wu N, Zhang Q, Zhu T. Estimating Spatiotemporal variation in ambient ozone exposure during 2013–2017 using a Data-Fusion Model. Environ Sci Technol. 2020;54(23):14877–88.PubMedCrossRef
19.
Xiao Q, Geng G, Xue T, Liu S, Cai C, He K, Zhang Q. Tracking PM(2.5) and O(3) Pollution and the Related Health Burden in China 2013–2020. Environ Sci Technol. 2022;56(11):6922–32.PubMedCrossRef
20.
Lv S, Li Z, Li H, Liu M, Wu Z, Yu S, Wu B, Gao B, Tao L, Luo Y, et al. Long-term effects of PM2.5 components on hypertension: a national analysis in China. Environ Res. 2023;222:115323.PubMedCrossRef
21.
Xia J, Zhuo Q, He YN. [Comparison of 24 hour dietary recalls with a food frequency questionnaire in evaluating dietary fat intakes]. Wei Sheng Yan Jiu. 2016;45(3):420–4.PubMed
22.
Yang YWG, Pan X. China Food Composition Tables. 6th ed. Beijing, China: Peking University Medical Press; 2018.
23.
Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334–57.PubMedCrossRef
24.
Wang L, Chen G, Pan Y, Xia J, Chen L, Zhang X, Silang Y, Chen J, Xu H, Zeng C, et al. Association of long-term exposure to ambient air pollutants with blood lipids in Chinese adults: the China multi-ethnic cohort study. Environ Res. 2021;197:111174.PubMedCrossRef
25.
Hu X, Nie Z, Ou Y, Lin L, Qian Z, Vaughn MG, McMillin SE, Zhou Y, Wu Y, Dong G, et al. Long-term exposure to ambient air pollution, circadian syndrome and cardiovascular disease: a nationwide study in China. Sci Total Environ. 2023;868:161696.PubMedCrossRef
26.
Yang Y, Yu D, Piao W, Huang K, Zhao L. Nutrient-derived beneficial for blood pressure Dietary Pattern Associated with Hypertension Prevention and Control: based on China Nutrition and Health Surveillance 2015–2017. Nutrients 2022, 14(15).
27.
Zheng B, Liu Q, Lyu J, Yu CQ. [Introduction of reduced rank regression and development of a user-written Stata package]. Zhonghua Liu Xing Bing Xue Za Zhi. 2022;43(3):403–8.PubMed
28.
Wang D, He Y, Li Y, Luan D, Yang X, Zhai F, Ma G. Dietary patterns and hypertension among Chinese adults: a nationally representative cross-sectional study. BMC Public Health. 2011;11:925.PubMedPubMedCentralCrossRef
29.
Guo C, Chang LY, Bo Y, Lin C, Lau AKH, Tam T, Lao XQ. Life-course exposure to ambient fine particulate matter and hypertension in adulthood: a longitudinal cohort study. Environ Sci Pollut Res Int. 2023;30(1):788–97.PubMedCrossRef
30.
Zhao M, Xu Z, Guo Q, Gan Y, Wang Q, Liu JA. Association between long-term exposure to PM(2.5) and hypertension: a systematic review and meta-analysis of observational studies. Environ Res 2022, 204(Pt D):112352.
31.
Jiangtulu B, Lan CX, Chen JX, Chen X, Wang B, Xue T. Ambient fine particulate matter exposure and blood pressure: evidence from a large Chinese multiple Follow-Up study. Biomed Environ Sci. 2023;36(1):38–49.PubMed
32.
Coogan PF, White LF, Yu J, Burnett RT, Seto E, Brook RD, Palmer JR, Rosenberg L, Jerrett M. PM2.5 and diabetes and hypertension incidence in the Black women’s Health Study. Epidemiology. 2016;27(2):202–10.PubMedPubMedCentral
33.
Xie X, Wang Y, Yang Y, Xu J, Zhang Y, Tang W, Guo T, Wang Q, Shen H, Zhang Y et al. Long-Term effects of ambient particulate matter (with an aerodynamic diameter ≤ 2.5 µm) on hypertension and blood pressure and attributable risk among Reproductive-Age adults in China. J Am Heart Assoc 2018, 7(9).
34.
Song J, Gao Y, Hu S, Medda E, Tang G, Zhang D, Zhang W, Li X, Li J, Renzi M, et al. Association of long-term exposure to PM(2.5) with hypertension prevalence and blood pressure in China: a cross-sectional study. BMJ Open. 2021;11(12):e050159.PubMedPubMedCentralCrossRef
35.
Curto A, Wellenius GA, Milà C, Sanchez M, Ranzani O, Marshall JD, Kulkarni B, Bhogadi S, Kinra S, Tonne C. Ambient Particulate Air Pollution and Blood pressure in peri-urban India. Epidemiology. 2019;30(4):492–500.PubMedPubMedCentralCrossRef
36.
Adar SD, Chen YH, D’Souza JC, O’Neill MS, Szpiro AA, Auchincloss AH, Park SK, Daviglus ML, Diez Roux AV, Kaufman JD. Longitudinal analysis of Long-Term Air Pollution levels and blood pressure: a cautionary tale from the multi-ethnic study of atherosclerosis. Environ Health Perspect. 2018;126(10):107003.PubMedPubMedCentralCrossRef
37.
Zhang J, Chen Q, Wang Q, Ding Z, Sun H, Xu Y. The acute health effects of ozone and PM(2.5) on daily cardiovascular disease mortality: a multi-center time series study in China. Ecotoxicol Environ Saf. 2019;174:218–23.PubMedCrossRef
38.
Song J, Lu M, Lu J, Chao L, An Z, Liu Y, Xu D, Wu W. Acute effect of ambient air pollution on hospitalization in patients with hypertension: a time-series study in Shijiazhuang, China. Ecotoxicol Environ Saf. 2019;170:286–92.PubMedCrossRef
39.
Liang S, Chen Y, Sun X, Dong X, He G, Pu Y, Fan J, Zhong X, Chen Z, Lin Z et al. Long-term exposure to ambient ozone and cardiovascular diseases: evidence from two national cohort studies in China. J Adv Res 2023.
40.
Liu Y, Dong J, Zhai G. Association between air pollution and hospital admissions for hypertension in Lanzhou, China. Environ Sci Pollut Res Int. 2022;29(8):11976–89.PubMedCrossRef
41.
Liao M, Braunstein Z, Rao X. Sex differences in particulate air pollution-related cardiovascular diseases: a review of human and animal evidence. Sci Total Environ. 2023;884:163803.PubMedCrossRef
42.
Clougherty JE. A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect. 2010;118(2):167–76.PubMedCrossRef
43.
Chen Z, Liu P, Xia X, Wang L, Li X. The underlying mechanism of PM2.5-induced ischemic stroke. Environ Pollut. 2022;310:119827.PubMedCrossRef
44.
Dong GH, Qian ZM, Xaverius PK, Trevathan E, Maalouf S, Parker J, Yang L, Liu MM, Wang D, Ren WH, et al. Association between long-term air pollution and increased blood pressure and hypertension in China. Hypertension. 2013;61(3):578–84.PubMedCrossRef
45.
Künzli N, Jerrett M, Mack WJ, Beckerman B, LaBree L, Gilliland F, Thomas D, Peters J, Hodis HN. Ambient air pollution and atherosclerosis in Los Angeles. Environ Health Perspect. 2005;113(2):201–6.PubMedCrossRef
46.
Fu L, Guo Y, Zhu Q, Chen Z, Yu S, Xu J, Tang W, Wu C, He G, Hu J, et al. Effects of long-term exposure to ambient fine particulate matter and its specific components on blood pressure and hypertension incidence. Environ Int. 2024;184:108464.PubMedCrossRef
47.
Kannel WB, Hjortland MC, McNamara PM, Gordon T. Menopause and risk of cardiovascular disease: the Framingham study. Ann Intern Med. 1976;85(4):447–52.PubMedCrossRef
48.
Zhang Y, Huang W, London SJ, Song G, Chen G, Jiang L, Zhao N, Chen B, Kan H. Ozone and daily mortality in Shanghai, China. Environ Health Perspect. 2006;114(8):1227–32.PubMedPubMedCentralCrossRef
49.
Xu R, Sun H, Zhong Z, Zheng Y, Liu T, Li Y, Liu L, Luo L, Wang S, Lv Z, et al. Ozone, Heat Wave, and Cardiovascular Disease Mortality: a Population-based case-crossover study. Environ Sci Technol. 2024;58(1):171–81.PubMedCrossRef
50.
Barthelemy J, Sanchez K, Miller MR, Khreis H. New opportunities to mitigate the Burden of Disease caused by Traffic Related Air Pollution: antioxidant-rich diets and supplements. Int J Environ Res Public Health 2020, 17(2).
51.
Huang K, Yu D, Fang H, Ju L, Piao W, Guo Q, Xu X, Wei X, Yang Y, Zhao L. Association of fine particulate matter and its constituents with hypertension: the modifying effect of dietary patterns. Environ Health. 2023;22(1):55.PubMedPubMedCentralCrossRef
52.
Xu H, Guo B, Qian W, Ciren Z, Guo W, Zeng Q, Mao D, Xiao X, Wu J, Wang X, et al. Dietary Pattern and Long-Term effects of Particulate Matter on blood pressure: a large cross-sectional study in Chinese adults. Hypertension. 2021;78(1):184–94.PubMedCrossRef
53.
Shi Z, Hu X, Yuan B, Pan X, Dai Y, Holmboe-Ottesen G. Association between dietary patterns and anaemia in adults from Jiangsu Province in Eastern China. Br J Nutr. 2006;96(5):906–12.PubMedCrossRef
54.
Ishimitsu T, Tobian L, Sugimoto K, Everson T. High potassium diets reduce vascular and plasma lipid peroxides in stroke-prone spontaneously hypertensive rats. Clin Exp Hypertens. 1996;18(5):659–73.PubMedCrossRef
55.
Rachima-Maoz C, Peleg E, Rosenthal T. The effect of caffeine on ambulatory blood pressure in hypertensive patients. Am J Hypertens. 1998;11(12):1426–32.PubMedCrossRef
56.
Godos J, Pluchinotta FR, Marventano S, Buscemi S, Li Volti G, Galvano F, Grosso G. Coffee components and cardiovascular risk: beneficial and detrimental effects. Int J Food Sci Nutr. 2014;65(8):925–36.PubMedCrossRef
57.
Shen J, He M, Lv R, Huang L, Yang J, Wu Y, Gu Y, Rong S, Yang M, Yuan C et al. Association of Mushrooms and Algae Consumption with Mortality among Chinese Older Adults: A Prospective Cohort Study. Nutrients 2022, 14(19).
58.
Pontifex MG, Vauzour D, Muller M. Sexual dimorphism in the context of nutrition and health. Proc Nutr Soc 2023:1–11.
59.
Bédard A, Corneau L, Lamarche B, Dodin S, Lemieux S. Sex-related differences in the effects of the mediterranean diet on glucose and insulin homeostasis. J Nutr Metab. 2014;2014:424130.PubMedPubMedCentralCrossRef
60.
Bédard A, Riverin M, Dodin S, Corneau L, Lemieux S. Sex differences in the impact of the Mediterranean diet on cardiovascular risk profile. Br J Nutr. 2012;108(8):1428–34.PubMedCrossRef
61.
Adams M, Sabaté J. Sexual dimorphism in Cardiovascular Disease risk and risk factors among vegetarians: an exploration of the potential mechanisms. Curr Atheroscler Rep. 2019;21(9):35.PubMedCrossRef
62.
Kim J, Kim H, Giovannucci EL. Quality of plant-based diets and risk of hypertension: a Korean genome and examination study. Eur J Nutr. 2021;60(7):3841–51.PubMedCrossRef
63.
Song S, Kim J, Kim J. Gender differences in the Association between Dietary Pattern and the incidence of hypertension in Middle-aged and older adults. Nutrients 2018, 10(2).
64.
Abramson BL, Melvin RG. Cardiovascular risk in women: focus on hypertension. Can J Cardiol. 2014;30(5):553–9.PubMedCrossRef
Metadata
Title
Sex differences and dietary patterns in the association of air pollutants and hypertension
Authors
Chen Zhang
Yuanyuan Wang
Wei Xie
Jingxian Zhang
Ting Tian
Qianrang Zhu
Xinyu Fang
Jing Sui
Da Pan
Hui Xia
Shaokang Wang
Guiju Sun
Yue Dai
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18620-9

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

Volunteering and instrumental support during the first phase of the pandemic in Europe: the significance of COVID-19 exposure and stringent country’s COVID-19 policy

Research

Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study

Research

Modeling COVID-19 spread using multi-agent simulation with small-world network approach

Research

Benchmarking the university campus food environment and exploring student perspectives about food insecurity and healthy eating: a case study from Australia

Research

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

Research

Physical and psychosocial challenges of people with gender dysphoria: a content analysis study