Abstract
BACKGROUND: Ambient fine particulate matter (PM(2.5)) is recognized as a hypertension and blood pressure (BP) risk factor, particularly among older adults. However, the associations between PM(2.5) and hypertension or BP in older adults remain unclear. This systematic review and meta-analysis aimed to quantify the associations between short- and long-term PM(2.5) exposure and hypertension prevalence and BP levels in older adults. METHODS: Our analysis was based on literature searches conducted in Embase, Web of Science, Cochrane Library, and PubMed up to September 25, 2023 and encompassed 2,223,978 participants. We employed a random-effects model to analyze the outcomes and used Cochran's c(2) test and I(2) test to assess heterogeneity among studies. Furthermore, we employed Begg's funnel plot and Egger's linear regression approach to quantitatively evaluate the presence of publication bias. All analyses were conducted using Stata 18.0. RESULTS: We retained 33 studies, comprising 9 short-term and 25 long-term studies. A 10 μg/m(3) increase in short-term exposure to PM(2.5) was associated with elevated BP, with systolic blood pressure (SBP) increasing by 0.45 mmHg (95% CI: 0.20, 0.69) and diastolic blood pressure (DBP) increasing by 0.24 mmHg (95% CI: 0.08, 0.40). Similarly, a 10 μg/m(3) elevation in long-term exposure to PM(2.5) was related to more substantial increases in SBP (1.58 mmHg; 95% CI: 0.80, 2.37) and DBP (0.90 mmHg; 95% CI: 0.39, 1.40). The long-term exposure to PM(2.5) was connected with a substantial augment in hypertension in older adults (OR = 1.18, 95% CI: 1.08, 1.28; HR = 1.21, 95% CI: 1.09, 1.34). CONCLUSION: Our study indicates that long-term PM(2.5) exposure has a more pronounced effect on BP and hypertension development than short-term exposure. Subgroup analysis revealed that females exhibited greater increases in SBP, while males demonstrated a higher hypertension risk.