@article{b0900e3efb4d4dbe86ecc4d804bd03ef,
title = "Ambient air pollution as a mediator in the pathway linking race/ethnicity to blood pressure elevation: The multi-ethnic study of atherosclerosis (MESA)",
abstract = "Background: Racial/ethnic disparities in blood pressure and hypertension have been evident in previous studies, as were associations between race/ethnicity with ambient air pollution and those between air pollution with hypertension. The role of air pollution exposure to racial/ethnic differences in hypertension has not been explored. Objective: To assess the potential mediating effects of ambient air pollution on the association between race/ethnicity and blood pressure levels. Methods: We studied 6,463 White, Black, Hispanic and Chinese adults enrolled across 6 US cities. Systolic (SBP) and diastolic blood pressure (DBP) were measured at Exam 1 (2000–2002) and Exam 2 (2002–2004). Household-level annual average concentrations of fine particulate matter (PM2.5), oxides of nitrogen (NOX), and ozone (O3) for the year 2000 were estimated for participants. Results: The difference in SBP levels by race/ethnicity that was related to higher PM2.5 concentrations compared with White men (“indirect associations”) was 0.3 (95% CI: 0.1, 0.6) mmHg for Black men, 0.3 (95% CI: 0.1, 0.6) mmHg for Hispanic men and 1.0 (95% CI: 0.2, 1.8) mmHg for Chinese men. Findings were similar although not statistically significant for women. PM2.5 did not mediate racial/ethnic differences in DBP. Indirect associations were significant for O3 for SBP among women and men and for DBP among men. In contrast, racial/ethnic disparities were attenuated due to exposure to NOX. Conclusion: Racial disparities in blood pressure were reduced after accounting for PM2.5 and ozone while increased after accounting for NOX.",
keywords = "Air pollution, Blood pressure, Disparities, Hypertension, Race/ethnicity",
author = "Lanxin Song and Smith, {Genee S.} and Adar, {Sara D.} and Post, {Wendy S.} and Eliseo Guallar and Ana Navas-Acien and Kaufman, {Joel D.} and Jones, {Miranda R.}",
note = "Funding Information: Hypertension is a highly prevalent condition relevant to many cardiovascular events in the US(Kochanek et al., 2016; Vital Signs, 2012). Racial/ethnic differences in hypertension prevalence and risk, have been shown in various studies (Redmond et al., 2011; Kramer et al., 2004; Rasmussen-Torvik et al., 2016; Fei et al., 2017) even after controlling for clinical risk factors of hypertension. The Chicago Area Sleep Study (CASS, 494 adults aged 35?64 years) (Rasmussen-Torvik et al., 2016), a cross-sectional study of Whites, Blacks, Hispanics and Chinese from Chicago, found that the prevalence of hypertension was highest in Blacks (36%), followed by Hispanics (14%), Asians (8%), and Whites (5%). In the Multi-Ethnic Study of Atherosclerosis (MESA), after multivariable adjustment, African American and Chinese race/ethnicity were significantly associated with hypertension compared to Whites (Kramer et al., 2004). Various factors have been suggested to account for the racial/ethnic disparities in hypertension, including genetic predisposition, awareness and management, obesity, sleep characteristics, SES, smoking, alcohol, social support, and chronic stress (Rasmussen-Torvik et al., 2016; Basu et al., 2014; Hicken et al., 2014a; Bosworth et al., 2006; Suglia et al., 2013; Kato, 2012; Thorpe et al., 2014; Bell et al., 2010).The Multi-Ethnic Study of Atherosclerosis (MESA) was supported by the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (contracts N01-HC-95159 through N01-HC-95165, and N01-HC-95169). This publication was developed under a STAR research assistance agreement awarded by the US Environmental Protection Agency (EPA) (EPA RD831697). It has not been formally reviewed by the EPA. MR Jones was supported by a NCI Diversity Supplement (U01 CA164975-05S1). Funding Information: The Multi-Ethnic Study of Atherosclerosis (MESA) was supported by the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (contracts N01-HC-95159 through N01-HC-95165 , and N01-HC-95169 ). This publication was developed under a STAR research assistance agreement awarded by the US Environmental Protection Agency (EPA) ( EPA RD831697 ). It has not been formally reviewed by the EPA. MR Jones was supported by a NCI Diversity Supplement ( U01 CA164975-05S1 ). Publisher Copyright: {\textcopyright} 2019",
year = "2020",
month = jan,
doi = "10.1016/j.envres.2019.108776",
language = "English (US)",
volume = "180",
journal = "Environmental Research",
issn = "0013-9351",
publisher = "Academic Press Inc.",
}