An exploration of the impact of air pollution on systolic blood pressure percentiles in children (3-9 years of age)
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Air pollution is a leading environmental health concern and early life exposures may have life-long implications. Prenatal air pollution exposure has been reported in association with blood pressure (BP) percentiles and elevated BP in infants and children, which are important predictors of future hypertension and consequently increased risk of cardiovascular (CV) disorders. However, the existing data is sparse and most previous studies used measurements from a single day. Trajectory modeling, which groups individuals with similar health outcomes over time, may be more useful for targeting wide-reaching clinical interventions. Our objective was to explore the association between NO2, PM2.5, and O3 and systolic BP percentile trajectories for 884 children in the Newborn Epigenetic Study, a diverse cohort based in North Carolina. Harvard and CMAQ pollutant concentrations were assigned by census tract across 90 days preconception, trimesters, and the entire pregnancy. We used multinomial logistic regression to estimate associations between the air pollutants and trajectory group membership (low stable [referent] (41%), low increasing (17%), high stable (30%) or high decreasing (12%)) adjusting for age, race, education, and season of conception. In main effects models, we saw a suggested ~12% increased odds of high stable group membership with preconception PM2.5 exposures. In the offspring of Black gestational parents (n=433), preconception PM2.5 exposures were associated with increased odds of high stable group membership [OR: 1.26 (1.08, 1.46)] (Harvard) and [OR: 1.23 (1.08, 1.41)] (CMAQ), while we saw a suggested ~10% decreased odds of high decreasing group membership with NO2 exposures in the offspring of White gestational parents (n=241), across all time points. Overall, our results suggest that air pollution may be associated with BP percentile trajectories. Our findings may be of clinical importance given the impact of early cardiometabolic outcomes on future CV health.