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A particulate threat to diabetics

Near-nanoscale air pollution boosts blood pressure

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4:45pm, October 26, 2011
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In a new study of people with diabetes, blood pressure rose in rough lockstep with short-term increases in soot and other microscopic air pollutant particles. Such transient increases in blood pressure can place the health of the heart, arteries, brain and kidneys at risk, particularly in people with chronic disease.

In contrast, when ozone levels climbed, blood pressure tended to fall among these people, independent of particulate levels. "And that was certainly not what we expected," notes study coauthor Barbara Hoffmann of the Leibniz Research Institute for Environmental Medicine in Düsseldorf, Germany.

Temperature also had an independent effect: A five-day average increase of 11.5 degrees Celsius, for instance, was associated with a small drop in blood pressure, Hoffmann and her colleagues report online October 21 in Environmental Health Perspectives.

Earlier studies suggested that particulates of the size measured in this study — just 2.5 micrometers in diameter — can hike blood pressure, particularly in people with diabetes.

To further investigate, Hoffman and her colleagues followed 70 Boston-area men and women, ages 40 to 85, with long-standing type 2 diabetes. All lived within 25 kilometers of a major air pollution monitoring station. Each participant submitted to repeated health tests at intervals of several weeks, which the researchers matched up with air pollution values from the preceding five days.

The team found pollution-related changes primarily in systolic blood pressure, the pressure exerted by the pumping action of each heartbeat. Systolic pressure is the top number in a blood pressure reading.

Since levels of particulates and ozone don’t necessarily track, one type of air pollutant cannot be expected to cancel out blood pressure alterations posed by the other, the researchers say. And ozone-associated drops in blood pressure aren’t necessarily beneficial. In fact, Hoffmann says, they offer additional evidence of a diabetes-related impairment in the ability of blood vessels to quickly adjust to changing environmental conditions by relaxing or constricting.

Changes in ozone and air pollution levels had no effect on people whose blood sugar was well controlled. Similarly, people with healthy baseline blood pressure readings exhibited little vulnerability to pollution.

"So especially if you want to positively influence your risk from air pollution," Hoffmann says, "it seems a very good idea to tightly control your blood pressure and your blood sugar."

The fact that a rise in concentrations of near-nanoscale particulates as small as 3.5 micrograms per cubic meter of air could raise systolic blood pressure “corroborates that current levels of particulate matter disrupt blood pressure control,” says physician Robert Brook of the Division of Cardiovascular Medicine at the University of Michigan Medical School in Ann Arbor. The new data, he maintains, confirm that short-term inhalation of fine airborne particulates at ambient levels — and perhaps traffic-related soot in particular — "have small but potentially clinically meaningful effects."

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