Long-term effects of PM2.5 components on hypertension: A national analysis in China.

Evidence is less about the associations between fine particulate matter (PM 2.5) components and hypertension. We aimed to examine the long-term effects of PM 2.5 components on prevalence of hypertension, diastolic blood pressure (DBP) and systolic blood pressure (SBP). We included participants between March 1, and July 31, 2021, from 13 provinces in China. Geocoded residential address was used for exposure assignment. Mixed-effect regression was used to assess 3-year average concentrations of PM 2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) on prevalence of hypertension, DBP and SBP with covariate-adjusted. SHapley Additive exPlanation was used to compare the contribution of PM 2.5 components to hypertension, DBP, and SBP. Sex and age subgroup were also analyzed. We enrolled a total of 113,159 participants aged ≥18 years. Long-term exposure to PM 2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) had associations with prevalence of hypertension, with the Odds Ratios and 95% confidence interval (CI) of 1.06 (95% CI : 1.03–1.09), 1.07 (95% CI : 1.04–1.09), 1.07 (95% CI : 1.04–1.10), 1.05 (95% CI : 1.01–1.08), 1.03 (95% CI : 1.00–1.06), and 1.03 (95% CI : 1.00–1.04), respectively. Effects of that except for black carbon on DBP with per interquartile upticks of concentration were 0.23 (95% CI : 0.11–0.35), 0.17 (95% CI : 0.04–0.29), 0.35 (95% CI : 0.21–0.48), 0.40 (95% CI : 0.28–0.52), and 0.25 (95% CI : 0.13–0.26), respectively. Ammonium was associated with SBP, corresponding to an increase of 0.18 (95% CI : 0.01–0.35). Males had higher risks of DBP (Z = 2.54–6.08, P < 0.001). Older people were substantially more affected by PM 2.5 and its components. Nitrate showed the highest contribution to hypertension, DBP and SBP compared with other components. Long-term exposure to PM 2.5 and its components had adverse consequences on prevalence of hypertension, DBP and SBP, especially for males and older people. Nitrate contributed the highest to hypertension, DBP and SBP. Findings may have implications for pollution and hypertension control. • Exposure to fine particulate matter (PM 2.5) components was related to hypertension. • PM 2.5 , nitrate and ammonium were associated with diastolic blood pressure. • Exposure to ammonium was associated with systolic blood pressure. • Nitrate contributed the highest to hypertension and blood pressure. • A nationwide study from 13 provinces in China during March 1, and July 31, 2021. [ABSTRACT FROM AUTHOR]