Meeting clean air targets could reduce the burden of hypertension among women of reproductive age in India

Objective: Air pollution is a prominent cardiovascular risk factor globally and poses a significant concern in low- and middle-income countries. This study shows the association between hypertension among women of reproductive age (WRA, 15–49 years) and exposure to PM2.5, a key pollutant. The aim of this study is to bridge the gap in epidemiological evidence, particularly within the context of India's hypertensive demographic. Aligned with Sustainable Development Goal (SDG) 3 which promotes good health and well being.

Materials and Methodology: Utilizing data from the National Family Health Survey-5 (NFHS-5) and satellite-driven PM2.5 exposure, we examined the links between hypertension and PM2.5 constituents. Logistic regression, adjusted for socioeconomic indicators, including age, smoking, residence, education, and cooking fuel. Multiplicative interactions explored the moderating effects of variables such as smoking,BMI, and residence on PM2.5.

Results: The adjusted odds ratio for hypertension increased by 1.05 (95% CI: 1.04–1.06) per 10 μg/m³ rise in ambient PM2.5, derived from satellite and MERRA-2 reanalysis (OR 1.04, 95% CI: 1.01-1.09). Notably, smokers exhibited a higher risk (OR 1.11, 95% CI: 1.10–1.16) compared to non-smokers (OR 1.05, 95% CI: 1.04–1.06). The economically vulnerable showed increased susceptibility (OR 1.07, 95% CI: 1.06–1.08). Dust and black carbon displayed stronger associations with hypertension (ORs 1.27 and 1.21, respectively). District-scale analysis suggested a potential 2.42% reduction if districts meet NCAP air quality targets, and a 4.21% reduction in prevalence of hypertension if WHO guidelines are met.

Conclusion: Addressing SDG 3, the study emphasizes a positive association between PM2.5 exposure and hypertension in WRA, shedding light on critical health challenges in developing countries. Dust and black carbon emerge as key contributors, emphasizing the need for targeted interventions. Achieving air quality targets and stricter adherence to WHO guidelines could substantially reduce hypertension prevalence, showcasing the study's relevance to global health and well-being goals. From the perspective of the Indian Hypertension Control Initiative, emphasizing the potential impact of policy interventions in mitigating cardiovascular risks associated with air pollution in India.