European Heart Journal Advance Access originally published online on December 3, 2004
European Heart Journal 2005 26(2):193-200; doi:10.1093/eurheartj/ehi035
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European Heart Journal vol. 26 no. 2 © The European Society of Cardiology 2004; all rights reserved.
Effects of air pollution on blood pressure and heart rate variability: a panel study of vehicular traffic controllers in the city of São Paulo, Brazil
1Divisão de Pneumologia, Instituto do Coração (InCor), Av. Dr Enéas de Carvalho Aguiar, 44, CEP 05403-000, São Paulo, SP, Brazil
2Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
3Environmental Pediatrics Program, University of Santo Amaro Medical School, São Paulo, Brazil
4Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
5Eletrocardiology Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
6Division of Occupational Health, FUNDACENTRO, São Paulo, Brazil
7Department of Epidemiology and Public Health, São José do Rio Preto Medical School, São José do Rio Preto, Brazil
Received 18 March 2004; revised 26 August 2004; accepted 9 September 2004; online publish-ahead-of-print 3 December 2004.
* Corresponding author. Tel/fax: +55 11 3082 7040. E-mail address: pneubiratan{at}incor.usp.br
Aims Evaluating the effects of air pollution on São Paulo city's vehicular traffic controllers by means of risk indicators for cardiovascular diseases.
Methods and results Twenty-four hour blood pressure recordings and an electrocardiogram were obtained in 48 healthy, non-smoking vehicular traffic controllers, aged 31–55 years, during three periods: winter 2000, summer 2001, and winter 2001. Effects of air pollutants on the outcomes were estimated using linear regression based on generalized estimated equations, controlling for age, body mass index, humidity, and temperature. An interquartile range (IQR) increase in CO (1.1 p.p.m.) was associated with increases of 2.6 mmHg (95% CI 1.0, 4.2), 1.8 mmHg (95% CI 0.8, 2.8), and 2.4 mmHg (95% CI 1.1, 3.6) in systolic, diastolic, and mean 24 h ambulatory blood pressures. SO2 also had relevant effects on blood pressure. On heart rate variability, an IQR increase of SO2 (9.6 µg/m3) was negatively associated with the standard deviation (SD) of normal RR intervals (SDNN) –7.93 ms (95% CI –15.3, –0.6).
Conclusion This study supplies biological plausibility for observational studies on air pollution-related cardiovascular morbidity and mortality.
Key Words: Panel study • Air pollution • Blood pressure • Heart rate variability
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