Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

Environmental Health

Research

Marwah Abdalla¹  Darby W. Jack²  Ashlinn K. Quinn²  Patrick L. Kinney³  Daichi Shimbo⁴  Blair J. Wylie⁵  Joseph E. Schwartz⁶  Kwaku Poku Asante⁷  Kenneth Ayuurebobi Ae-Ngibise⁷  Seyram Kaali⁷  Seth Owusu-Agyei⁷  Ellen Boamah⁷  Oscar Agyei⁷  Mohammed Mujtaba⁷  Steven N. Chillrud⁸ 

[1] Center for Behavioral Cardiovascular Health, Columbia University, New York, NY, USA;Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St, 11th floor, 10032, New York, NY, USA;Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA;Department of Medicine, Columbia University Medical Center, New York, NY, USA;Division of Maternal-Fetal Medicine, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;Institute for Applied Behavioral Medicine Research, Stony Brook University, Stony Brook, NY, USA;Center for Behavioral Cardiovascular Health, Columbia University, New York, NY, USA;Kintampo Health Research Centre, Ghana Health Service, Brong Ahafo Region, Kintampo, Ghana;Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA;

关键词: Household air pollution;    Carbon monoxide;    Blood pressure;    Ambulatory blood pressure monitoring;    Cookstoves;    Biomass;   

DOI  :  10.1186/s12940-017-0282-9

 received in 2017-01-24, accepted in 2017-06-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRepeated exposure to household air pollution may intermittently raise blood pressure (BP) and affect cardiovascular outcomes. We investigated whether hourly carbon monoxide (CO) exposures were associated with acute increases in ambulatory blood pressure (ABP); and secondarily, if switching to an improved cookstove was associated with BP changes. We also evaluated the feasibility of using 24-h ambulatory blood pressure monitoring (ABPM) in a cohort of pregnant women in Ghana.MethodsParticipants were 44 women enrolled in the Ghana Randomized Air Pollution and Health Study (GRAPHS). For 27 of the women, BP was measured using 24-h ABPM; home blood pressure monitoring (HBPM) was used to measure BP in the remaining 17 women. Personal CO exposure monitoring was conducted alongside the BP monitoring.ResultsABPM revealed that peak CO exposure (defined as ≥4.1 ppm) in the 2 hours prior to BP measurement was associated with elevations in hourly systolic BP (4.3 mmHg [95% CI: 1.1, 7.4]) and diastolic BP (4.5 mmHg [95% CI: 1.9, 7.2]), as compared to BP following lower CO exposures. Women receiving improved cookstoves had lower post-intervention SBP (within-subject change in SBP of −2.1 mmHg [95% CI: -6.6, 2.4] as compared to control), though this result did not reach statistical significance. 98.1% of expected 24-h ABPM sessions were successfully completed, with 92.5% of them valid according to internationally defined criteria.ConclusionsWe demonstrate an association between acute exposure to carbon monoxide and transient increases in BP in a West African setting. ABPM shows promise as an outcome measure for assessing cardiovascular health benefits of cookstove interventions.Trial registrationThe GRAPHS trial was registered with clinicaltrials.gov on 13 April 2011 with the identifier NCT01335490.

【 授权许可】

CC BY   
© The Author(s). 2017