Arq. Bras. Cardiol. 2023; 120(11): e20230347

Excess Systolic Blood Pressure Associated with Fine Particulate Matter Air Pollution above the WHO Guidelines in Brazil

Pedro Rafael Vieira de Oliveira Salerno , Issam Motairek, Luis Augusto Palma Dallan, Brendan Bourges-Sevenier, Sanjay Rajagopalan, Sadeer G. Al-Kindi

DOI: 10.36660/abc.20230347

Introduction

Cardiovascular disease remains the leading cause of mortality worldwide, and hypertension has been implicated as having the highest association of causation among all of the cardiovascular disease risk factors. Thus, unsurprisingly, hypertension is the main risk factor for death and the second major cause of disability-adjusted life years in Brazil, heavily impacting its population and national healthcare system. It is also directly linked to air pollution, especially fine particulate matter < 2.5 microns (PM _2.5 ), which has been identified as an independent risk factor for increased systolic blood pressure (SBP). In Brazil, as in most countries, the main source of exposure to air pollution in urban areas primarily results from the burning of fossil fuels via vehicular traffic and industrial power generation, while, in rural Brazil, air pollution mainly results from the burning of biomass as well as deforestation.

In Brazil, previous studies have been conducted investigating the effects of PM _2.5 exposure on blood pressure in outdoor workers who are most susceptible to ambient air pollution from vehicular emissions, such as traffic controllers, demonstrating the link between PM _2.5 concentration and increased SBP. ^, However, these studies tend to focus on metropolitan and urban regions. ^, Thus, due to Brazil’s large geographical size and regional diversity, there exists a substantial gap in knowledge in the less populated areas. In this study, we aimed to estimate the excess SBP attributable to PM _2.5 concentrations above the threshold of the World Health Organization (WHO) guidelines in Brazil, as well as in all its states and regions.

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