Air pollution in homes can increase blood pressure in adults — Experts

Certainly, hypertension is a complex phenomenon and its development involves interaction between various factors, such as genetics, lifestyle, and environmental factors in which air pollution plays a major role. The risks from air pollution are now far greater than previously thought or understood, particularly for hypertension.

Now, in a new study, researchers said short-term exposure to household air pollution can raise the blood pressure in an individual. In fact, short‐term exposure to air pollution from most cooking stoves produced a delayed increase in systolic pressure that was observable within 24 hours.

In a pilot study in Ibadan, the researchers after investigating the association between household air pollution and risk of hypertension among adults said the use of improved cooking fuel such as gas and electricity to reduced indoor air pollution is a preventive measure of hypertension.

High blood pressure is a systolic pressure of 130 or higher or a diastolic pressure of 80 or higher, that stays high over time.

The 2020 study was published in the Journal of Health and Environmental Research. It involved Abiodun Moshood Adeoye, Adekunle Fakunle, Olajumoke Aderonmu and Bamidele Tayo.

“Pollution is known risk factor for hypertension and we discovered that not many people are really paying attention to it,” declared Dr Abiodun Adeoye, the study’s lead author.

Dr Adeoye, a consultant cardiologist at the University College Hospital, Ibadan, stated that attention, most times, is paid to adherence to intake of hypertension medicines, but never to the environment or level of pollution in homes of individuals with hypertension.

He declared, “There is a lot of pollution in the environment both within and outside the house. Prolonged exposure to all these can lead to persistent blood pressure. This has been proven in other parts of the world. That is what spurred us to do that study.

“Our study has implicated fine particulate matter (PM2.5) concentrations within the indoor environment as an independent significant predictor of hypertension among adults in Nigeria. A similar study carried out among women in rural areas of China reported that women who use biomass cooking stoves in their kitchen have increased blood pressure.

“Similarly, another randomized control trial in Ibadan proved the blood pressure in pregnant women given clean fuel to cook was less than in those still using unimproved methods of cooking because of lesser exposure to household air pollutants.”

According to Dr Adeoye, inhaled fine and coarse particles from the indoor environment attach themselves to the lining of the blood vessels and subsequently cause them to become narrower and harder. When blood vessel volume is lowered, blood flow is also reduced. At the same time, the resistance or force of blood flow is raised. This causes higher blood pressure. It can also lead to other problems like stroke and cognition impairment.

Professor Godson Ana, an environmental health expert at the Department of Environmental Health Sciences, Faculty of Public Health at the University of Ibadan, stated that studies have proven that exposure to air pollution triggers a cascade of reactions in the body, thus predisposing to many conditions that affect the blood vessels, heart and the lungs.

According to Professor Ana, air pollutants which could either be in the gaseous or particulate matter form or a combination of both, affect different organs of the body differently.

He declared, “Air pollution, for instance, can cause a range of health problems, including chronic obstructive pulmonary disorder, aggravate asthmatic problems, predispose to eye problems like conjunctivitis and so on.”

The environmental health expert, however, declared that despite the enormity of its consequences, individuals take it for granted because it is not like garbage or solid wastes.

He stated that since 2016, the World Health Organisation (WHO) had declared air pollution as the number one risk factor contributing to the global burden of diseases, claiming lives and affecting more the vulnerable groups like the children, the elderly and the pregnant women.

Symptoms often linked to poor indoor air quality include dryness and irritation of the eyes, nose, throat, and skin; headache, fatigue, shortness of breath, dizziness, hypersensitivity and allergies as well as coughing and sneezing.

The study had involved 25 individuals between 51 and  60 years of age being treated for hypertension at the outpatient clinic of the University College Hospital, Ibadan, and another 25 individuals without hypertension living in the same geographical areas as the hypertensive patients between July and October 2019.

They were interviewed using a structured questionnaire to accrue basic demographic, household environment information, family smoking characteristics, and cooking pattern.  Also, indoor environmental temperature and relative humidity, including the concentrations of particulate matter from the kitchen, bedroom, sitting room and the outdoor environment, were monitored in their homes over a 24-hour period.

The participants had a 24-hour ambulatory blood pressure monitoring. The machine was programmed to read every 20 minutes during the wake period and half-hourly at night.  They were encouraged to proceed with their routine daily activities and to record daytime napping in the diary provided.

Besides, household conditions were assessed among participants, including types of building occupied by household, household size described as the total number of individuals older than 18 years, the number of rooms in the building and cooking fuel type.

According to the study, a significant association was observed between the type of building inhabited and hypertensive status. Also, the concentration of indoor pollution in houses of individuals with hypertension was significantly higher than the values obtained in homes of others with normal blood pressure.

Houses that use unimproved cooking fuel (kerosene, firewood, and charcoal) had higher levels of indoor pollutants than houses that use improved cooking fuel type (Gas and electricity).

Similarly, blood pressure values taken in the clinic moderately correlated with the level of air pollution they were exposed to. Likewise, day-time ambulatory systolic blood pressure correlated positively with the level of air pollution, too.

Overall, subjects having more than five persons living in the same house were nine times more likely to be hypertensive compared to those with less than five persons.

Interestingly, this current study among black Africans found a significantly higher concentration of both PM2.5 and PM10 (particles with a diameter of 10 micrometres) in homes of adults with hypertension than homes of adults with normal blood pressure readings.

Also, from this study, households that make use of unimproved fuel was exposed to a higher level of particulate air pollutants than the WHO 24-hours threshold limit, supporting the notion that short‐term exposure to air pollution from most cooking stoves produced a delayed increase in systolic pressure that was observable within 24 hours.

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