Life-course exposure to ambient fine particulate matter and hypertension in adulthood: a longitudinal cohort study.

PM-hypertension association were well documented in adults, while the effects of life-course exposure to PM on adulthood hypertension remained unclear. This study aimed to investigate the associations between life-course exposure to ambient PM and incident hypertension in adulthood in Asia. We included 4272 participants with 17,814 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. We used a satellite-based model to assess 2-year average PM exposure at a resolution of 1 km. A linear mixed model was used to examine the association with blood pressure. A Cox regression model with time-dependent covariates was used to examine the overall association with the development of hypertension in adulthood. Life-course mixed models were used to examine the effects of PM exposure at different life stages on blood pressure and hypertension. For every 10 μg/m increase in PM, the overall risk of adulthood hypertension increased by 40% (95% confidence interval [CI] 8-80%). The health effects of PM exposure at different life-stages on incident hypertension were generally independent of each other. In critical model, the risk of developing hypertension increased 23%, 27%, and 55% for each 10 μg/m increase in PM exposure during school age, adolescence, and adulthood, respectively. Similar associations were found between life-course PM exposure and blood pressure. Association between PM and adulthood hypertension can be traced back to childhood. Our study suggests that life-course control of air pollution exposure should be implemented to alleviate the huge burden of adulthood hypertension.