HypertensionResearch article

Short-Term Exposure to Air Pollution Increases Mortality From Hypertension and its Multiorgan Complications

J Am Coll CardiolPublished

  • Case-crossover study
  • nationwide
  • individual-level
  • time-stratified

Authors' conclusion

Air pollution acts as an acute stressor superimposed on hypertensive patients, creating a mortality risk gradient determined by the severity of comorbidity.

Study context

Population
Hypertension-related deaths across mainland China, 2013–2019
Participants
>2.1 million hypertension-related deaths
Comparison
Short-term air pollution exposure (PM2.5, PM10, NO2, O3) across hypertensive disease progression stages
Outcome
Hypertension mortality risk per IQR increase in air pollutants
Follow-up
Lag 02 days (average of lag 0-2 days)

Main finding

As reported in the abstract

Mortality risk per IQR increase in PM2.5

Further findings

OutcomeUncomplicated primary hypertensionHypertensive heart diseaseHypertensive kidney diseaseHypertensive heart and kidney disease with cardiorenal failure
Deaths attributable to PM2.5 (cardiorenal failure phenotype) · highest attributable fractionNot reported in the abstractNot reported in the abstractNot reported in the abstract4.20% (95% CI 3.55%–4.85%)

Pollutant comparison

NO2 consistently showed the strongest associations among 4 air pollutants

Exposure-response curves

Approximately linear for all 4 pollutants, no apparent threshold

Vulnerable subgroups

More vulnerable: female sex, age ≥65 years, northern residence, lower educational attainment, no spousal support, cold season

Original publication

Short-Term Exposure to Air Pollution Increases Mortality From Hypertension and its Multiorgan Complications. J Am Coll Cardiol. Published 25 February 2026. doi:10.1016/j.jacc.2026.01.006

Summarised from the published abstract; every number is checked against it