Unraveling the Environmental, Meteorological, and Lifestyle Determinants of Hypertension Mortality in Türkiye

Year 2024, , 103 - 114, 29.06.2024

Mehmet Koçak , Özgenç Aktaş-koçak

https://doi.org/10.52675/jhesp.1491484

Abstract

Hypertension is a leading risk factor for cardiovascular diseases and a significant cause of mortality worldwide. This study investigates the association of environmental, meteorological, and lifestyle factors with hypertension mortality in Türkiye from 2010 to 2019. This study analyzed province-level hypertension mortality data for 81 provinces in Türkiye from 2010 to 2019. Predictors included air quality indicators (particulate matter 10, sulfur dioxide, carbon monoxide, nitrogen dioxide, ozone), meteorological variables (air pressure, humidity, temperature, wind speed), and lifestyle factors (smoking, alcohol consumption, exposure to second-hand smoke). An ordinal logistic regression approach was employed to model the likelihood of hypertension mortality, with adjustments for multiple testing using the Benjamini-Hochberg False Discovery Rate technique. In this study, it was found that significant associations are between hypertension mortality and several predictors. Air pressure, in terms of coefficient of variation and median levels, was significantly associated with hypertension mortality. Temperature and humidity showed strong associations, with median levels and variability impacting mortality rates. Lifestyle factors, notably smoking and alcohol consumption, were also significantly associated with increased hypertension mortality. Surprisingly, exposure to smoke at home showed a slight protective effect. The study highlights the complex interplay of environmental, meteorological, and lifestyle factors in terms of influencing hypertension mortality in Türkiye. These findings emphasize the need for multifaceted public health strategies that consider these diverse influences to manage and prevent hypertension-related mortality effectively.

Keywords

Environmental Factors, Hypertension, Lifestyle Factors, Meteorological Factors, Mortality, Turkey

References

• Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B (Methodological),57(1), 289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
• Brown, I. J., Tzoulaki, I., Candeias, V., & Elliott, P. (2009). Salt intakes around the world: Implications for public health. International Journal of Epidemiology, 38(3), 791–813.
• Buford, T. W. (2016). Hypertension and aging. Ageing Research Reviews, 26, 96–111.
• Chen, H., Burnett, R. T., Kwong, J. C., Villeneuve, P. J., Goldberg, M. S., Brook, R. D., van Donkelaar,A., Jerrett, M., Martin, R.V, Kopp, A., Brook, J.R, & Copes, R. (2014). Spatial association between ambient fine particulate matter and incident hypertension. Circulation, 129(5), 562–569. https://doi.org/10.1161/CIRCULATIONAHA.119.044171
• Chen, H., & Zhang, X. (2023). Influences of temperature and humidity on cardiovascular disease among adults 65 years and older in China. Frontiers in Public Health, 10, 1079722.
• Cohen, A. J., & Aaron J. (2017). Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: An analysis of data from the Global Burden of Diseases Study 2015. The Lancet, 1907–1918.
• Jehn, M., Appel, L. J., Sacks, F. M., & Miller, E. R. (2002). The effect of ambient temperature and barometric pressure on ambulatory blood pressure variability. American Journal of Hypertension, 15(11), 941–945.
• Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29(3), 374–393.
• Lee, J. T., Son, J. Y., & Cho, Y. S. (2019). The adverse effects of humidity on the risk of cardiovascular and respiratory diseases: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 16(7), 1156.
• Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2020). Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation, 134(6), 441–450. https://doi.org/10.1161/ CIRCULATIONAHA.115.018912
• Rajagopalan, S., Al-Kindi, S. G., & Brook, R. D. (2018). Air pollution and cardiovascular disease: JACC state-of-the-art review. Journal of the American College of Cardiology, 72(17), 2054–2070. https://doi.org/10.1016/j.jacc.2018.07.099
• Roerecke, M., Tobe, S. W., Kaczorowski, J., Bacon, S. L., Vafaei, A., Hasan, O. S. M., Krishnan, R.J, Raifu, A.O, & Rehm, J. (2017). Sex-specific associations between alcohol consumption and incidence of hypertension: A systematic review and meta-analysis of cohort studies. Journal of the American Heart Association, 7(13), e008202. https://doi.org/10.1161/JAHA.117.005748
• Rostand, S. G., McClure, L. A., Kent, S. T., Judd, S. E., & Gutiérrez, O. M. (2016). Associations of blood pressure, sunlight, and vitamin D in community-dwelling adults. Journal of Hypertension, 34(9), 1704–1710.
• Virdis, A., Giannarelli, C., Neves, M. F., Taddei, S., & Ghiadoni, L. (2010). Cigarette smoking and hypertension. Current Pharmaceutical Design, 16(23), 2518–2525.
• Yang, L., Li, L., Lewington, S., Guo, Y., Sherliker, P., Bian, Z., Collins, R., Peto, R., Liu, Y., Yang, R., Zhang, Y., Li, G., Liu, S., & Chen, Z. (2015). Outdoor temperature, blood pressure, and cardiovascular disease mortality among 23,000 individuals with diagnosed cardiovascular diseases from China. European Heart Journal, 36(19), 1178–1185.