TY - JOUR
T1 - Lack of association between chronic exposure to biomass fuel smoke and markers of right ventricular pressure overload at high altitude
AU - Caravedo, Maria A.
AU - Painschab, Matthew S.
AU - Davila-Roman, Victor G.
AU - De Ferrari, Aldo
AU - Gilman, Robert H.
AU - Vasquez-Villar, Angel D.
AU - Pollard, Suzanne L.
AU - Miranda, J. Jaime
AU - Checkley, William
N1 - Funding Information:
The study population was comprised of adults (aged ≥35 years) living in Puno, Peru (population ~150, 000), and surrounding rural communities at 3, 825 m above sea level. City-dwellers work chiefly in commerce and education and cook predominantly with clean fuels including liquid-propane gas, kerosene, and electricity. Rural-dwellers live as subsistence farmers and cook indoors almost exclusively with traditional, open-fire stoves, and use combinations of wood, animal dung, and crop residue as fuel. All participants provided verbal informed consent after our research team read the entire informed consent document to them and any questions were answered. Informed consents were verbal because of high illiteracy rates. The study protocol was approved by the Johns Hopkins University in Baltimore, USA, and AB PRISMA and Universidad Peruana Cayetano Heredia in Lima, Peru. This work was supported by the Center for Global Health of Johns Hopkins University and by the National Heart, Lung and Blood Institute, United States National Institutes of Health. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper and its final contents.
Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Background: Chronic exposure to biomass fuel smoke has been implicated in the development of pulmonary hypertension and right ventricular pressure/volume overload through activation of inflammation, increase in vascular resistance, and endothelial dysfunction. We sought to compare N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography-derived pulmonary artery systolic pressure (PASP) levels in a high-altitude population-based study in Peru with and without chronic exposure to biomass fuel smoke.Methods: NT-pro-BNP levels were measured in 519 adults (275 with and 244 without chronic exposure to biomass fuel smoke). Participants answered sociodemographics and clinical history questionnaires, underwent a clinical examination and blood testing for cardiopulmonary biomarkers. PASP was measured in a subgroup of 153 (31%) subjects.Results: The study group consisted of 280 men (54%) and 239 women (46%). Average age was 56 years and average body mass index was 27 kg/m2. In multivariable analysis, there was no association between chronic exposure to biomass fuel smoke and NT-pro-BNP (P =.31) or PASP (P =.31). In the subgroup in which both NT-pro-BNP levels and PASP were measured, there was strong evidence of an association between these two variables (ρ = 0.24, 95% CI 0.09-0.39; P =.003). We found that age, high sensitivity C-reactive protein, being male, and systolic blood pressure were positively associated with NT-pro-BNP levels whereas body mass index, low-density/high-density lipoprotein ratio, and Homeostasis Model of Assessment-Insulin Resistance were negatively associated (all P ≤.02).Conclusions: In this population-based study in a high-altitude setting, neither NT-pro-BNP levels nor echocardiography-derived PASP were associated with chronic exposure to biomass fuel smoke.
AB - Background: Chronic exposure to biomass fuel smoke has been implicated in the development of pulmonary hypertension and right ventricular pressure/volume overload through activation of inflammation, increase in vascular resistance, and endothelial dysfunction. We sought to compare N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography-derived pulmonary artery systolic pressure (PASP) levels in a high-altitude population-based study in Peru with and without chronic exposure to biomass fuel smoke.Methods: NT-pro-BNP levels were measured in 519 adults (275 with and 244 without chronic exposure to biomass fuel smoke). Participants answered sociodemographics and clinical history questionnaires, underwent a clinical examination and blood testing for cardiopulmonary biomarkers. PASP was measured in a subgroup of 153 (31%) subjects.Results: The study group consisted of 280 men (54%) and 239 women (46%). Average age was 56 years and average body mass index was 27 kg/m2. In multivariable analysis, there was no association between chronic exposure to biomass fuel smoke and NT-pro-BNP (P =.31) or PASP (P =.31). In the subgroup in which both NT-pro-BNP levels and PASP were measured, there was strong evidence of an association between these two variables (ρ = 0.24, 95% CI 0.09-0.39; P =.003). We found that age, high sensitivity C-reactive protein, being male, and systolic blood pressure were positively associated with NT-pro-BNP levels whereas body mass index, low-density/high-density lipoprotein ratio, and Homeostasis Model of Assessment-Insulin Resistance were negatively associated (all P ≤.02).Conclusions: In this population-based study in a high-altitude setting, neither NT-pro-BNP levels nor echocardiography-derived PASP were associated with chronic exposure to biomass fuel smoke.
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U2 - 10.1016/j.ahj.2014.06.030
DO - 10.1016/j.ahj.2014.06.030
M3 - Article
C2 - 25440802
AN - SCOPUS:84908374501
SN - 0002-8703
VL - 168
SP - 731
EP - 738
JO - American heart journal
JF - American heart journal
IS - 5
ER -